Value of Head and Neck 4D-CTA Combined with SDF-1a/CXCR4 Signaling Pathway in Assessing the Risk of Ruptured Intracranial Posterior Communicating Aneurysms
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摘要:
目的 探讨利用4D-CTA结合SDF-1a／CXCR4 信号通路评估颅内后交通动脉瘤破裂风险的价值。 方法 将 50 名未破裂颅内前交通动脉瘤患者和 50 名破裂颅内前交通动脉瘤患者分为未破裂组 1 和破裂组 1。所有患者均接受 4D-CTA 检查并检测血清SDF-1a水平。非破裂组 1 接受了 12 个月的随访后把后脉瘤破裂的患者被纳入破裂组 2，动脉瘤未破裂的患者被纳入非破裂组 2。 结果 诊断颅内后交通动脉瘤破裂的 Wn、AR、L、SR、SDF-1a 及其组合的 AUC 值均大于 0.70。破裂组 2 Wn、AR、L、SR和SDF-1a及其组合预测颅内后交通动脉瘤破裂的AUC值均大于0.70。 结论 4D-CTA 联合SDF-1a能有效区分破裂的颅内后交通动脉瘤并预测破裂风险。 -
关键词:
- 4D-CTA /
- 基质细胞衍生因子-1 /
- 颅内后交通动脉瘤破裂
Abstract:Objective To investigate the value of 4D-CTA combined with SDF-1a/CXCR4 signaling pathway in evaluating the risk of intracranial aneurysm rupture. Methods Fifty patients with unruptured intracranial posterior communicating aneurysms and 50 patients with ruptured intracranial posterior communicating aneurysms were divided into unruptured group 1 and ruptured group 1. All patients underwent 4D-CTA examination and serumSDF-1alevel was detected. Non-ruptured group 1 was followed up for 12 months（After conservative treatment）, on this basis, patients with ruptured posterior communicating aneurysms were included in ruptured group 2, and patients with unruptured posterior communicating aneurysms were included in non-ruptured group 2. Results The AUC values of Wn, AR, L, SR, SDF-1a and their combinations in diagnosing ruptured intracranial posterior communicating aneurysms were all greater than 0.70.The AUC values of Wn, AR, L, SR, SDF-1a and their combinations in predicting ruptured intracranial posterior communicating aneurysms in ruptured group 2 were all greater than 0.70. Conclusion 4D-CTA combined with SDF-1acan effectively distinguish ruptured intracranial posterior communicating aneurysms and predict the risk of rupture. -
Key words:
- 4D-CTA /
- SDF-1a /
- Ruptured posterior intracranial communicating aneurysm
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图 3 AR、SR 及 VOR 数值 测量图示并动脉瘤基底部见异常搏动点（黄箭头所示）
Figure 3. Diagram of 4D measurement of AR，SR，and VOR values（shown by yellow arrow）
图 4 4D-CTA成像 后交通动脉异常搏动点（绿箭头）
Figure 4. Abnormal pulse points of Traffic artery after 4D-CTA （green arrow）
图 5 4D-CTA联合SDF-1对颅内后交通动脉瘤破裂的诊断价值
Figure 5. Diagnostic value of 4D-CTA combined with SDF-1 in the rupture of intracranial posterior communicating aneurysms
图 6 4D-CTA联合SDF-1对颅内后交通动脉瘤破裂的预测价值
Figure 6. Predictive value of 4D-CTA combined with SDF-1 for ruptured intracranial aneurysms
表 1 破裂组1和非破裂组1 SDF-1对比[μg/L，（$\bar x \pm s $）]
Table 1. Comparison of SDF-1 between unruptured group 1 and ruptured group 1 [μg/L，（$\bar x \pm s $）]
组别 SDF-1 破裂组 1 （n=50） 135.03±11.01 非破裂 1 （n=50） 149.48±13.22 T 5.900 P <0.001* *P<0.05。 
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表 2 4D-CTA联合SDF-1对颅内后交通动脉瘤破裂的诊断价值
Table 2. Diagnostic value of 4D-CTA combined with SDF-1 in the rupture of intracranial posterior communicating aneurysms.
因素 AUC 临界值 95%CI P 特性异 敏感性 Wn 0.844 2.990 0.765～0.923 <0.001* 0.760 0.860 AR 0.888 1.115 0.818～0.958 <0.001* 0.840 0.900 L 0.834 4.585 0.758～0.909 <0.001* 0.660 0.820 SR 0.771 1.255 0.679～0.863 <0.001* 0.680 0.740 SDF-1 0.800 141.155 0.712～0.887 <0.001* 0.760 0.760 Combination 0.976 0.953～0.999 <0.001* 0.880 0.960 *P<0.05。
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表 3 破裂组2和非破裂组2 SDF-1对比[μg/L，（$\bar x \pm s $）]
Table 3. Comparison of SDF-1 between unruptured group 2 and ruptured group 2 [μg/L，（$\bar x \pm s $）]
组别 SDF-1 破裂组2 （n=19） 142.38±11.22 非破裂2 （n=31） 128.13±10.22 t 4.660 P <0.001* *P<0.05。
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表 4 联合SDF-1对颅内后交通动脉瘤破裂的预测价值
Table 4. Predictive value of combined SDF-1 for rupture of intracranial posterior communicating aneurysms
因素 AUC 临界值 95%CI P 特性异 敏感性 Wn 0.926 2.710 0.856～0.996 <0.001* 0.871 0.842 AR 0.705 1.065 0.546～0.863 0.016 0.710 0.632 L 0.744 4.215 0.579～0.910 0.004 0.742 0.737 SR 0.792 1.115 0.652～0.932 0.001 0.645 0.789 SDF-1 0.847 133.510 0.742～0.952 <0.001* 0.710 0.789 Combination 0.973 − 0.928～1.000 <0.001* 0.903 0.947 *P<0.05。
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