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Abstract：
Various surgical and anatomical classifications have been proposed to date related to ACoA aneurysm projection. Nonetheless, a universally accepted classification system is yet to be established. This study is aimed at establishing a standardized classification system for ACoA aneurysms with utilization 3D technology and defining reference lines for their projections. The goal is to create a simple, understandable, surgically beneficial, and reliable classification system based on neurovascular structures in the region, including safe and hazardous zones. The radiologic data of 96 patients with ACoA aneurysm who were treated in our university hospital between 2012 and 2020 were retrospectively analyzed, and a planned classification scale was developed with the data obtained. The classification aimed to create 9 main projection groups in the sagittal plane: superior, inferior, anterior, and posterior in linear orientation, and anterosuperior, posterosuperior, anteroinferior, posteroinferior, and complex in quadrant orientation. The coronal and axial planes included medial, lateral, and midline classifications, resulting in a 3-dimensional classification system with 25 projections. Among the 96 patients, 32 had linear and 64 had quadrant projections. In the sagittal plane, the linear projection breakdown was as follows: superior (28%), inferior (6.25%), anterior (53%), and posterior (12.5%). For the quadrant projection, the distribution was as follows: anterosuperior (53%), posterosuperior (12.5%), anteroinferior (21.87%), posteroinferior (3.12%), and complex (9.37%). Overall, 35.4% aneurysms were anterosuperior, 17.7% anterior, 14.58% anteroinferior, 9.37% superior, 8.3% posterosuperior, 6.25% complex, 4.16% posterior, 2.08% posteroinferior, and 2.08% inferior projection. Our study proposes a projection classification that utilizes 3D technology for safe surgery based on neurovascular structures in the region and thus better reveals safe and hazardous zones, including three plans, three dimensions, and two orientations. The use of this classification system offers valuable guidance for daily practice in the treatment of ACoA aneurysms.
摘要：
迄今为止，已经提出了与ACoA动脉瘤投影有关的各种外科和解剖学分类。尽管如此，一个普遍接受的分类系统尚未建立。本研究旨在利用3D技术建立ACoA动脉瘤的标准化分类系统，并为其预测定义参考线。我们的目标是创建一个简单的，可以理解,手术有益，和基于该区域神经血管结构的可靠分类系统，包括安全和危险区域。回顾性分析2012～2020年我院收治的96例ACoA动脉瘤患者的影像学资料,并根据获得的数据制定了计划的分类量表。该分类旨在在矢状面创建9个主投影组：上，劣等,前,线性取向向后，和前上，后上级，前下，后下，复杂的象限方向。冠状面和轴向面包括内侧，横向,和中线分类，产生具有25个投影的3维分类系统。在96名患者中，32具有线性突起,64具有象限突起。在矢状平面上,线性预测分解如下：优越(28%)，劣质（6.25%），前（53%），和后部(12.5%)。对于象限投影，分布如下：前上（53%），后上(12.5%)，前下侧（21.87%），后劣质(3.12%)，和复杂（9.37%）。总的来说,35.4%的动脉瘤位于前上，17.7%前牙，前下侧14.58%，优于9.37%，8.3%后级优越，6.25%复杂，4.16%后，2.08%后下，和2.08%的劣后预测。我们的研究提出了一种投影分类，利用3D技术进行基于该区域神经血管结构的安全手术，从而更好地揭示安全和危险区域，包括三个计划，三个维度,和两个方向。该分类系统的使用为ACoA动脉瘤的日常治疗提供了有价值的指导。
