Xiaopeng Cui, Yan Zhao, Liang Wang, Yujing Jin, Zhenglong Yang, Yaohua Li, Zilin Zhao, Hengrui Zhang, Kai Wei, Zhennan Sun, Peng Huai, Lei Chen, Xinyu Yang
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Among Chinese individuals, the prevalence, distribution, and clinical, geometric, and local hemodynamic characteristics of small- and medium-sized (<15 mm) blebbed IAs remain unclear.</p><p><strong>Objectives: </strong>To investigate the prevalence, distribution, and associated clinical, geometric, and hemodynamic features of blebs in small- and medium-sized IAs among Chinese patients, and to identify predictors of aneurysm rupture and bleb formation.</p><p><strong>Design: </strong>A retrospective observational study.</p><p><strong>Methods: </strong>CTA or DSA data from 214 patients with ruptured (RIAs) and unruptured IAs (UIAs) (<15 mm), with or without blebs, were analyzed. Three-dimensional reconstruction, geometric measurement, and computational fluid dynamics (CFD) analysis were conducted using Mimics and ANSYS Fluent. Hemodynamic parameters were assessed across the neck, body, and dome, and logistic regression was used to identify predictors of rupture and bleb formation.</p><p><strong>Results: </strong>Aneurysms from 214 patients (93 men, 121 women; mean age 59.90 ± 11.76 years) were analyzed. Blebs were found in 107 aneurysms (56.7% of RIAs, 39.1% of UIAs). They were more frequent in ACoA, PCoA, and bifurcation aneurysms (all <i>P</i> < 0.05) and were associated with rupture. RIAs had larger blebs than UIAs (2.73 ± 1.28 mm vs 2.06 ± 1.07 mm, <i>P</i> = 0.009). Blebbed IAs exhibited larger size, more irregular shape, higher AR, SR, BN, HWR, and lower NWSS, TAWSS, OSI (all <i>P</i> < 0.05). SR was the strongest rupture predictor (AUC = 0.718, SR > 1.3144). Aneurysms at ACoA (OR = 8.812,CI:2.455-31.634), PCoA (OR = 6.376,CI:2.094-19.414), and high SR (OR = 2.738,CI:0.98-7.651) were significant rupture risk factors. PCoA (OR = 2.261,CI:0.759-6.739) and SR (OR = 4.683,CI:1.937-11.324) independently predicted bleb formation.</p><p><strong>Conclusion: </strong>Blebs are common in small- and medium-sized IAs, especially at the ACoA, PCoA, and bifurcations, and are associated with an increased risk of rupture. Larger blebs are more often seen in ruptured IAs. A high SR is a key predictor of both rupture and bleb formation. Further studies on bleb-related hemodynamics in the neck, body, and dome are warranted.</p>","PeriodicalId":15218,"journal":{"name":"Journal of Central Nervous System Disease","volume":"17 ","pages":"11795735251364919"},"PeriodicalIF":2.8000,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329196/pdf/","citationCount":"0","resultStr":"{\"title\":\"Prevalence, Geometry, and Hemodynamics of Small and Medium-Sized Intracranial Aneurysms With and Without Blebs in the Chinese Han Population.\",\"authors\":\"Xiaopeng Cui, Yan Zhao, Liang Wang, Yujing Jin, Zhenglong Yang, Yaohua Li, Zilin Zhao, Hengrui Zhang, Kai Wei, Zhennan Sun, Peng Huai, Lei Chen, Xinyu Yang\",\"doi\":\"10.1177/11795735251364919\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Blebs are small bulges on the surface of intracranial aneurysms (IAs) that increase rupture risk. Among Chinese individuals, the prevalence, distribution, and clinical, geometric, and local hemodynamic characteristics of small- and medium-sized (<15 mm) blebbed IAs remain unclear.</p><p><strong>Objectives: </strong>To investigate the prevalence, distribution, and associated clinical, geometric, and hemodynamic features of blebs in small- and medium-sized IAs among Chinese patients, and to identify predictors of aneurysm rupture and bleb formation.</p><p><strong>Design: </strong>A retrospective observational study.</p><p><strong>Methods: </strong>CTA or DSA data from 214 patients with ruptured (RIAs) and unruptured IAs (UIAs) (<15 mm), with or without blebs, were analyzed. Three-dimensional reconstruction, geometric measurement, and computational fluid dynamics (CFD) analysis were conducted using Mimics and ANSYS Fluent. Hemodynamic parameters were assessed across the neck, body, and dome, and logistic regression was used to identify predictors of rupture and bleb formation.</p><p><strong>Results: </strong>Aneurysms from 214 patients (93 men, 121 women; mean age 59.90 ± 11.76 years) were analyzed. Blebs were found in 107 aneurysms (56.7% of RIAs, 39.1% of UIAs). They were more frequent in ACoA, PCoA, and bifurcation aneurysms (all <i>P</i> < 0.05) and were associated with rupture. RIAs had larger blebs than UIAs (2.73 ± 1.28 mm vs 2.06 ± 1.07 mm, <i>P</i> = 0.009). Blebbed IAs exhibited larger size, more irregular shape, higher AR, SR, BN, HWR, and lower NWSS, TAWSS, OSI (all <i>P</i> < 0.05). SR was the strongest rupture predictor (AUC = 0.718, SR > 1.3144). Aneurysms at ACoA (OR = 8.812,CI:2.455-31.634), PCoA (OR = 6.376,CI:2.094-19.414), and high SR (OR = 2.738,CI:0.98-7.651) were significant rupture risk factors. PCoA (OR = 2.261,CI:0.759-6.739) and SR (OR = 4.683,CI:1.937-11.324) independently predicted bleb formation.</p><p><strong>Conclusion: </strong>Blebs are common in small- and medium-sized IAs, especially at the ACoA, PCoA, and bifurcations, and are associated with an increased risk of rupture. Larger blebs are more often seen in ruptured IAs. A high SR is a key predictor of both rupture and bleb formation. Further studies on bleb-related hemodynamics in the neck, body, and dome are warranted.</p>\",\"PeriodicalId\":15218,\"journal\":{\"name\":\"Journal of Central Nervous System Disease\",\"volume\":\"17 \",\"pages\":\"11795735251364919\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-08-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329196/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Central Nervous System Disease\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/11795735251364919\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Central Nervous System Disease","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/11795735251364919","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：气泡是颅内动脉瘤表面的小凸起，增加破裂的风险。目的：调查中国患者中中小型IAs中水泡的患病率、分布及相关的临床、几何和血流动力学特征，并确定动脉瘤破裂和水泡形成的预测因素。设计：回顾性观察性研究。方法：214例动脉瘤破裂（RIAs）和未破裂（UIAs）患者的CTA或DSA数据(结果：214例动脉瘤患者(男性93例，女性121例；平均年龄59.90±11.76岁)。107例动脉瘤（56.7%的RIAs， 39.1%的uas）中发现了小泡。在ACoA、PCoA和分叉动脉瘤中更为常见（均P < 0.05），并与破裂相关。RIAs明显大于uas（2.73±1.28 mm vs 2.06±1.07 mm, P = 0.009）。起泡后的IAs尺寸更大，形状更不规则，AR、SR、BN、HWR更高，NWSS、TAWSS、OSI更低（P < 0.05）。SR是最强的破裂预测因子（AUC = 0.718, SR > 1.3144）。ACoA （OR = 8.812,CI:2.455 ~ 31.634）、PCoA （OR = 6.376,CI:2.094 ~ 19.414）和高SR （OR = 2.738,CI:0.98 ~ 7.651）是动脉瘤破裂的重要危险因素。PCoA （OR = 2.261,CI:0.759-6.739）和SR （OR = 4.683,CI:1.937-11.324）独立预测气泡形成。结论：水泡在中小型IAs中很常见，特别是在ACoA， PCoA和分叉处，并且与破裂的风险增加有关。较大的气泡更常见于破裂的IAs。高SR是破裂和水泡形成的关键预测指标。进一步研究与颈部、身体和穹隆的水泡相关的血流动力学是有必要的。
Prevalence, Geometry, and Hemodynamics of Small and Medium-Sized Intracranial Aneurysms With and Without Blebs in the Chinese Han Population.
Background: Blebs are small bulges on the surface of intracranial aneurysms (IAs) that increase rupture risk. Among Chinese individuals, the prevalence, distribution, and clinical, geometric, and local hemodynamic characteristics of small- and medium-sized (<15 mm) blebbed IAs remain unclear.
Objectives: To investigate the prevalence, distribution, and associated clinical, geometric, and hemodynamic features of blebs in small- and medium-sized IAs among Chinese patients, and to identify predictors of aneurysm rupture and bleb formation.
Design: A retrospective observational study.
Methods: CTA or DSA data from 214 patients with ruptured (RIAs) and unruptured IAs (UIAs) (<15 mm), with or without blebs, were analyzed. Three-dimensional reconstruction, geometric measurement, and computational fluid dynamics (CFD) analysis were conducted using Mimics and ANSYS Fluent. Hemodynamic parameters were assessed across the neck, body, and dome, and logistic regression was used to identify predictors of rupture and bleb formation.
Results: Aneurysms from 214 patients (93 men, 121 women; mean age 59.90 ± 11.76 years) were analyzed. Blebs were found in 107 aneurysms (56.7% of RIAs, 39.1% of UIAs). They were more frequent in ACoA, PCoA, and bifurcation aneurysms (all P < 0.05) and were associated with rupture. RIAs had larger blebs than UIAs (2.73 ± 1.28 mm vs 2.06 ± 1.07 mm, P = 0.009). Blebbed IAs exhibited larger size, more irregular shape, higher AR, SR, BN, HWR, and lower NWSS, TAWSS, OSI (all P < 0.05). SR was the strongest rupture predictor (AUC = 0.718, SR > 1.3144). Aneurysms at ACoA (OR = 8.812,CI:2.455-31.634), PCoA (OR = 6.376,CI:2.094-19.414), and high SR (OR = 2.738,CI:0.98-7.651) were significant rupture risk factors. PCoA (OR = 2.261,CI:0.759-6.739) and SR (OR = 4.683,CI:1.937-11.324) independently predicted bleb formation.
Conclusion: Blebs are common in small- and medium-sized IAs, especially at the ACoA, PCoA, and bifurcations, and are associated with an increased risk of rupture. Larger blebs are more often seen in ruptured IAs. A high SR is a key predictor of both rupture and bleb formation. Further studies on bleb-related hemodynamics in the neck, body, and dome are warranted.
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