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首页> 美国卫生研究院文献>Frontiers in Neurology >Bifurcation Configuration Is an Independent Risk Factor for Aneurysm Rupture Irrespective of Location
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Bifurcation Configuration Is an Independent Risk Factor for Aneurysm Rupture Irrespective of Location

机译：分叉构型是与部位无关的动脉瘤破裂的独立危险因素

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>Background: Bifurcation and sidewall aneurysms have different rupture risks, but whether this difference comes from the location of the aneurysm is not clear. The objective of this study is to illustrate the rationality of ranking bifurcation configuration as an independent risk factor for aneurysm rupture.>Methods: Morphological features of 719 aneurysms (216 ruptured) were automatically extracted from a consecutive cohort of patients via PyRadiomics. Rupture risks and morphological features were compared between bifurcation and sidewall aneurysms, and lasso regression was applied to explore the morphological determinants for rupture in bifurcation and sidewall aneurysms. Rupture risks and morphological features of bifurcation aneurysms in different locations were analyzed. Multivariate regression was performed to explore the risk factors for aneurysm rupture.>Results: Twelve morphological features were automatically extracted from PyRadiomics implemented in Python. The rupture risks were higher in bifurcation aneurysms (P < 0.01), and morphological features Elongation and Flatness were much lower in ruptured bifurcation than sidewall aneurysms (P = 0.036, 0.011, respectively). Elongation and Flatness were the morphological determinants for rupture in bifurcation aneurysms, whereas Elongation and SphericalDisproportion were determinants for sidewall aneurysms. Different rupture risks and morphological features were found between sidewall and bifurcation aneurysms of the same location, and among bifurcation aneurysms of different locations. In multivariate regression, bifurcation configuration was an independent risk factor for aneurysm rupture (OR 3.007, 95% CI 1.752–5.248, P < 0.001).>Conclusions: Sidewall and bifurcation aneurysms and bifurcation aneurysms of different locations have different rupture risks and morphological features. Bifurcation configuration is an independent risk factor for aneurysm rupture irrespective of location.
机译：>背景：分叉和侧壁动脉瘤的破裂风险不同，但是这种差异是否来自动脉瘤的位置尚不清楚。这项研究的目的是说明将分叉构型列为动脉瘤破裂的独立危险因素的合理性。>方法：从连续的一组患者中自动提取了719个动脉瘤（216个破裂）的形态特征通过PyRadiomics。比较了分叉和侧壁动脉瘤的破裂风险和形态学特征，并应用套索回归分析探讨了分叉和侧壁动脉瘤破裂的形态学决定因素。分析了分叉动脉瘤在不同部位的破裂风险和形态特征。进行多变量回归以探讨动脉瘤破裂的危险因素。>结果：从Python中实现的PyRadiomics中自动提取了十二种形态特征。分叉动脉瘤的破裂风险较高（P <0.01），而分叉动脉瘤的形态特征伸长率和平坦度要比侧壁动脉瘤低得多（分别为P = 0.036、0.011）。伸长率和平坦度是分叉动脉瘤破裂的形态学决定因素，而伸长率和球形不均匀度是侧壁动脉瘤的决定因素。在相同位置的侧壁和分叉动脉瘤之间，以及在不同位置的分叉动脉瘤之间，发现了不同的破裂风险和形态学特征。在多元回归分析中，分叉形态是动脉瘤破裂的独立危险因素（OR 3.007，95％CI 1.752-5.248，P <0.001）。>结论：侧壁和分叉动脉瘤以及不同部位的分叉动脉瘤都有不同的破裂风险和形态特征。无论位置如何，分叉构型都是动脉瘤破裂的独立危险因素。

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