摘要
目的探究脑底动脉环(Willis)、切应力(WSS)及环壁张力(CWT)联合检测在单发颅内动脉瘤(IA)中的预测价值。方法选择2017年6月至2018年9月在金华市中心医院接受治疗的经数字减影血管造影(DSA)确诊的IA患者70例作为观察组,另选同期DSA检查为阴性者70例作为对照组。通过三维DSA检查及三维重建图像来判断A1优势征、Willis后环变异情况,通过颅彩色多普勒超声(TCD)来获得患者血流动力学参数,计算WSS、CWT值,比较两组患者Willis环变异类型和血流动力学参数方面的差异。采用受试者工作曲线(ROC)下面积(AUC)比较Willis变异、CWT、WSS三者单独及联合检测对IA的预测价值。结果观察组A1优势征合计率、Willis环变异率均明显高于对照组(χ^(2)=48.721、52.502,P <0.05),观察组的WSS和CWT明显高于对照组(t=6.263、2.265,P <0.05);Willis变异、CWT、WSS联合诊断IA的ROC曲线下AUC分别为0.800、0.655、0.796、0.911。联合诊断IA的AUC值明显大于Willis变异、CWT、WSS诊断IA的AUC值(Z=2.648、4.841、2.553,P <0.05)。结论 Willis、WSS及CWT联合检测IA具有较高的诊断价值。
Objective To explore the predictive value of combined detection of basal cerebral artery ring(Willis),arterial wall shear stress(WSS)and circumferential wall tension(CWT)in single intracranial aneurysm(IA).Methods A total of 70 IA patients diagnosed by digital subtraction angiography(DSA)in Jinhua central hospital from June 2017 to September 2018 were selected as observation group,another 70 cases with negative DSA examination in the corresponding period were selected as control group.Three-dimensional DSA and three-dimensional reconstructed images were used to judge A1 dominance and Willis posterior ring variation.Hemodynamic parameters were obtained by transcranial color duplex ultrasonography(TCD),then WSS and CWT were calculated,the differences of Willis ring variation and hemodynamic parameters between the two groups were compared.The predictive value of Willis mutation,CWT and WSS alone and in combination in IA was compared by area(AUC)under the receiver operating curve(ROC).Results The total rate of A1 dominant sign and Willis variation rate in the observation group were significantly higher than those in the control group(χ^(2)=48.721,52.502,P<0.05),the WSS and CWT in the observation group were significantly higher than those in the control group(t=6.263,2.265,P<0.05).The AUC under ROC curve of Willis variation,CWT,WSS and joint diagnostic IA were 0.800,0.655,0.796 and 0.911,respectively.The AUC under the ROC curve of diagnostic IA was significantly larger than that under Willis variation,CWT,WSS diagnostic IA(Z=2.648,4.841,2.553,P<0.05).Conclusion The combined detection of IA with Willis,WSS and CWT has high diagnostic value.
作者
刘晓波
叶志军
周格知
袁坚列
Liu Xiaobo;Ye Zhijun;Zhou Gezhi;Yuan Jianlie(Department of Neurosurgery,Jinhua Central Hospital,Jinhua 321000,China)
出处
《心脑血管病防治》
2021年第1期47-49,67,共4页
CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT
基金
浙江省科技计划项目(2019C03044)。
关键词
脑底动脉环
切应力
环壁张力
联合检测
颅内动脉瘤
Basal cerebral artery ring
Arterial wall Shear stress
Circumferential wall tension
Combined detection
Intracranial aneurysm
