Correlation Study of Rupture Risk in Intracranial Unruptured Aneurysms: Integration of Mannose-binding lectin、Hydrodynamics and Morphology

Abstract

Abstract Background The purpose of this study is to explore the interconnection between Mannose-Binding Lectin (MBL) and fluid dynamics in the context of rupture risk associated with intracranial unruptured aneurysms. Methods 68 cases of intracranial unruptured aneurysms were selected from patients treated at Wenzhou Central Hospital between June 2020 and December 2022. Based on MBL concentrations, cases were categorized into three groups: <0.80 mg/L for the low concentration group, 0.80–1.10 mg/L for the moderate concentration group, and > 1.10 mg/L for the high concentration group. Geometric and computational fluid dynamics were employed to calculate morphological and hemodynamic parameters. PHASES score was calculated for each case to estimate rupture risk. Univariate and multivariate logistic regression analyses were conducted to investigate the relationship between morphological-hemodynamic patterns and MBL, as well as their association with rupture risk. Results Among them, there were 30 cases in the low concentration group (44.1%), 25 cases in the moderate concentration group (36.8%), and 13 cases in the high concentration group (19.1%). Size ratio, wall shear stress, velocity, low wall shear stress, and relative residence time (RRT) were identified as independent risk factors associated with elevated serum MBL concentration in intracranial unruptured aneurysms. With an increase in PHASES score, there is a significant rise in size-related parameters and the frequency of irregular shapes. Additionally, lower and oscillatory wall shear stress is observed, along with a lower intra-aneurysmal flow velocity and prolonged residence time, indicative of altered hemodynamic patterns. Simultaneously, there is a decrease in the proportion of low MBL concentrations, while the proportions of moderate and high MBL concentrations in aneurysms show a significant increase(P < 0.001). Conclusions The serum MBL concentration levels in patients with intracranial unruptured aneurysms are closely associated with their aneurysmal morphology and hemodynamics. Intracranial unruptured aneurysms at higher risk of rupture tend to exhibit larger and irregular shapes, characterized by fluid dynamics with low and variable wall shear stress. Additionally, these aneurysms show elevated serum MBL concentrations.