【摘要】 目的 研究脑血管形态学类型与脑动脉瘤形成的相关性。方法 截取1081份正常MRA图像定义为一般国人脑血管形态学类型,按颈内动脉供血范围进行分型,将一侧颈内动脉只供应同侧大脑前动脉和大脑中动脉定义为标准均衡型,将一侧颈内动脉不仅供应同侧大脑中动脉和大脑前动脉同时还供应对侧全部或部分大脑前动脉,而对侧大脑前动脉A1段明显变细(管径<对侧1/2)、发育不良或未发育定义为一侧优势型,将一侧大脑后动脉主要由同侧颈内动脉通过胚胎大脑后动脉供血定义为前循环优势型进行分析。对175例动脉瘤患者脑血管形态学类型与一般国人脑血管形态学类型进行对照,研究脑血管形态学类型与脑动脉瘤形成的相关性。结果 49例前交通动脉瘤中一侧优势型占87.76%(45例),与正常国人一侧优势型和标准均衡型构成有显著性差异(P<0.0001)。其中左侧优势型(33例)约为右侧优势型(12例)的3倍,与一般人群左侧优势与右侧优势型比(11.19%/3.98%)无显著性差异(P=0.952)。而且左右侧前交通动脉瘤数目构成与临床一般人群一侧优势型左右侧构成无显著性差异(P=0.544)。58例颈内动脉一后交通动脉瘤患者中前循环优势型(21例)与标准均衡型(27例)构成与正常国人脑血管类型前循环优势型(224例)及标准均衡型(762例)构成存在显著性差异(P=0.0008)。前交通动脉瘤、后交通动脉瘤、多发动脉瘤中脑血管类型异常比例均与正常国人脑血管类型异常比例之间存在显著性差异,而M1远端分叉处动脉瘤脑血管类型异常比例与正常国人脑血管类型异常比例之间不存在显著性差异。结论 一侧优势型供血与前交通动脉瘤的形成相关,造成前交通动脉瘤左右侧差异的原因是因为一侧优势型发育左右侧存在差异。Willis环的变异是Willis环上动脉瘤形成的一个重要因素。更多还原

【Abstract】 Objective To investigate the correlative factors between various type of cerebral vessels and aneurysms.Methods1081 normal magnetic resonance angiography(MRA) images were collected and on which the shapes of cerebral vessels were defined as that in general crowd.According to the blood-supply scope of internal carotid artery(ICA),ICA only supplied homolateral anterior cerebral artery(ACA) and middle cerebral artery(MCA) were defined as typical balanced,ICA not only supplied homolateral ACA and MCA,but also opposite ACA through anterior communicating artery(ACoA) and Al segment of ACA maldevelopment or nulli-development were defined as one-sided dominant,ICA not only supplied homolateral MCA and or without ACA,but also homolateral posterior communicating artery(PCA) through fetal type PCA were defined as pro-circulation dominant,analysis occurrence of various type.The correlative factors between the type of cerebral vessels and formation of cerebral aneurysms were analysed.Results In 49 anterior communicating aneurysms,one-sided dominant was found in 87.76%(45/49),compared to incidence of onesided dominant in general crowd(11.19%) had significant difference(χ~2=151.84,P<0.0001),in which left dominant(33/49) was triple of right dominant(12/49) approximately(63.27%/24.49%),in comparison to composition of general crowd(11.19%/3.98 %) had not statistically significant(χ~2=0.0497,P=0.8235),and the number of anterior communicating aneurysms in left and right had not significant compared composition of one-sided dominant in left and right in general crowd(P=0.544).The composition of pro-circulation dominant in posterior communicating aneurysms(21/48) and normal condition(224/762) had significant difference(χ~2=11.1984,P=0.0008).Abnormal type of cerebral vessels in anterior communicating aneurysms(45/49),posterior communicating aneurysms(31/58),muti-aneurysms(16/31) and the type of normal condition had significant difference.Abnormal type of cerebral vessels in M1 segment of MCA aneurysms(9/20) and the type of normal condition had not statistically significant.Conclusion Anterior communicating aneurysms and one-sided dominant blood-supply has positive correlation,the reasons of different left and right anterior communicating aneurysms is development different in one-sided dominant.The variation of Willis circle was important factor in formation of aneurysms in Willis circle.更多还原