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Abstract：
The microsurgical management of posterior communicating artery (PCoA) aneurysms can be modified depending on their localization, with respect to the tentorial edge consisting of the anterior petroclinoid ligament (APCL). However, the imaging of APCL has been impractical to date. In this study, we evaluated a simple method for assessing the relationship between PCoA aneurysms and APCL, using three-dimensional computed tomographic angiography (3D-CTA). We retrospectively reviewed all surgically treated cases of PCoA aneurysms via the pterional approach in our institute from May 2013 to August 2018. To predict the localization of the aneurysms, three anatomical lines were drawn on non-subtracted volumetric 3D-CTA as follows: 1. the apex of the anterior clinoid process to the posterior border of the trigeminal depression of the petrosal bone (AACP-PBTD); 2. AACP to the superior edge of the arcuate eminence (AACP-SEAE); 3. the base of the ACP to the superior edge of the arcuate eminence (BACP-SEAE). The relative location of each line to the PCoA aneurysms was compared with actual intraoperative findings. Fifty-six aneurysms were included. The sensitivity, specificity, and positive and negative predictive values of the superior localization of the aneurysm of the AACP-TDPB line were 93.8%, 40.0%, 38.5%, and 94.1%, respectively. Those of the AACP-SEAE line were 93.8%, 42.5%, 39.5, and 94.4%, respectively. In contrast, those of the BACP-SEAE line were 93.8%, 97.5%, 93.8%, and 97.5%, respectively. The BACP-SEAE line is a simple and practical landmark in predicting APCL.
摘要：
后交通动脉（PCoA）动脉瘤的显微外科治疗可以根据其定位进行修改，关于由前岩样韧带（APCL）组成的幕部边缘。然而,迄今为止,APCL的成像是不切实际的.在这项研究中,我们评估了一种评估PCoA动脉瘤与APCL之间关系的简单方法，使用三维计算机断层血管造影（3D-CTA）。我们回顾性回顾了2013年5月至2018年8月在我们研究所通过翼点入路手术治疗的所有PCoA动脉瘤病例。为了预测动脉瘤的定位，在非减除体积3D-CTA上绘制如下三条解剖线:1.前斜突顶点至岩骨三叉神经凹陷（AACP-PBTD）的后边界；2.AACP至弓形隆起的上边缘（AACP-SEAE）；3.ACP的底部到弓形隆起（BACP-SEAE）的上边缘。将每条线与PCoA动脉瘤的相对位置与实际术中发现进行比较。包括56个动脉瘤。敏感性,特异性，AACP-TDPB线动脉瘤优越定位的阳性预测值和阴性预测值分别为93.8％，40.0%,38.5%,94.1%，分别。AACP-SEAE系的比例为93.8%，42.5%,39.5%和94.4%，分别。相比之下,BACP-SEAE品系的比例为93.8%，97.5%,93.8%,97.5%,分别。BACP-SEAE线是预测APCL的简单实用标志。
