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A scoring system to discriminate blood blister-like aneurysms: a multidimensional study using patient-specific model

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Abstract

Presurgical discrimination of blood blister-like aneurysms (BBAs) can assist neurosurgeons in clinical decision-making. The aim of this study was to investigate the characteristics of BBAs and construct a useful tool to distinguish BBAs. This study reviewed patients with small/median, hemispherical, and wide-necked aneurysms of the internal carotid artery in our institution. BBAs were identified via their intraoperative findings. A hemodynamic analysis was performed using a patient-specific model. The independent risk factors of BBAs were investigated using a logistic analysis. A scoring system was then established to discriminate BBAs, in which its predicting value was analyzed using receiver operating characteristic (ROC) analysis. A total of 67 aneurysms comprising 21 BBAs were enrolled. Comparing features between BBAs and non-BBAs, statistical significances were found in the aspect ratio (AR), height-to-width ratio, aneurysm angle (AA), wall shear stress gradient (WSSG), and normalized wall shear stress average. A multivariate logistic analysis identified AR (OR = 0.29, p = 0.021), WSSG (OR = 1.54, p = 0.017) and AA (OR = 2.49, p = 0.039) as independent risk factors for BBAs. A scoring system was constructed using these parameters, effectively distinguishing BBAs (AUC = 0.931, p < 0.01). Our multidimensional scoring system may effectively assist in the discrimination of BBAs from wide-necked non-BBAs.

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Funding

This study was supported by the “National Natural Science Foundation of China” (Grant No. 81671129 and 81471210) and “Major special projects in the 13th five-year plan” (Grant No.2016YFC1301800).

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Author notes

  1. Shanwen Chen and Qingyuan Liu contributed equally to this work.

Authors and Affiliations

  1. Department of Neurosurgery, Bei**g Tiantan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Bei**g, 100070, China

    Shanwen Chen, Qingyuan Liu, Maogui Li, Pengjun Jiang, Yi Yang, Yong Cao, Jun Wu & Shuo Wang

  2. China National Clinical Research Center for Neurological Diseases, Bei**g, People’s Republic of China

    Maogui Li, Pengjun Jiang, Yi Yang, Yong Cao, Jun Wu & Shuo Wang

  3. Department of Blood Transfusion, Bei**g Tiantan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Bei**g, 100070, China

    Nuochuan Wang & Yanan Zhang

  4. School of Life Science and BioEngineering, Bei**g University of Technology, Bei**g, 100124, China

    Bin Gao

  5. Department of Neurosurgery, Union Hospital, Fujian Medical University, 29 **nquan Road, Fuzhou City, 350001, Fujian, China

    Baogang Ren

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  1. Shanwen Chen
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Contributions

Author contributions to the study and manuscript preparation include the following. Conception and design: SC and QL. Acquisition of data: QL, YY, PJ, and ML. Analysis and interpretation of data: QL, YY, and BG. Drafting the article: QL. Critically revising the article: JW and SW. Reviewing submitted version of manuscript: all authors. Approving the final version of the manuscript on behalf of all authors: SW. Administrative/technical/material support: BR, NW, YZ, and YC. Study supervision: SW.

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Correspondence to Jun Wu or Shuo Wang.

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The work was approved by the Institutional Review Board of Tiantan Hospital (ky2019-096-02).

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Chen, S., Liu, Q., Ren, B. et al. A scoring system to discriminate blood blister-like aneurysms: a multidimensional study using patient-specific model. Neurosurg Rev 44, 2735–2746 (2021). https://doi.org/10.1007/s10143-020-01465-2

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