Objective: : Blood-blister aneurysms (BBAs) of the internal carotid artery (ICA) are challenging lesions with high morbidity and mortality rates. Although research on BBAs is well documented in different populations, the study of BBAs in the Tibetan population is extremely rare. This study aimed to evaluate the characteristics of BBAs and analyze the treatment modalities and long-term outcomes in the Tibetan population in comparison with the Han population. Methods: : The characteristics of patients with BBAs of the ICA from January 2009 to January 2021 at our institution were reviewed. The features of aneurysms, treatment modalities, complications, and follow-up outcomes were retrospectively analyzed. Results: : A total of 130 patients (41 Tibetan and 89 Han patients) with BBAs of the ICA who underwent treatment were enrolled. Compared with the Han group, the Tibetan group significantly demonstrated a high ratio of BBAs among ICAs (8.6%, 41/477 vs. 1.6%, 89/5563; p<0.05), a high ratio of vasospasm (34.1%, 14/41 vs. 6.7%, 6/89; p=0.001), a high risk of ischemic events (43.9%, 18/41 vs. 22.5%, 20/89; p<0.05), and a low ratio of good outcomes (modified Rankin scale, 0–2) at the 1-year follow-up (51.2%, 21/41 vs. 74.2%, 66/89; p<0.05). The multivariate regression model showed that ischemic events significantly contributed to the prediction of outcomes at 1 year. Further analysis revealed that microsurgery and vasospasm were associated with ischemic events. Conclusion : In comparison with Han patients, the Tibetan population had a high ratio of BBA occurrence, a high incidence of ischemic events, and a high ratio of poor outcomes. The endovascular approach showed more benefits in BBA patients.

Objective To explore the feasibility of constructing a short-term therapeutic efficacy prediction model for hepatocellular carcinoma(HCC)after radiofrequency ablation(RFA)based on texture analysis of preoperative MRI arterial phase images.Methods A retrospective analysis was conducted on 169 HCC patients treated with RFA.Based on the short-term therapeutic efficacy,the patients were divided into a good prognosis group(112 cases)and a poor prognosis group(57 cases).Texture features of preoperative MRI arterial phase images were extracted using Mazda software,and dimension reduction was performed through Fisher coefficient,mutual information,classification error probability,and mean correlation coefficient.The patients were divided into a training group(n=119)and a testing group(n=50)in a 7∶3 ratio.Independent sample t-tests and the least absolute shrinkage and selection operator(LASSO)algorithm were employed for further feature selection.Subsequently,a radiomics model was established using LASSO regression and evaluated through the receiver operating characteristic(ROC)curve and area under the curve(AUC).Results The radiomics model comprised features such as S_2__2_SumOfSqs,Teta1,S_5_0_DifVarnc,S_2_0_DifEntrp,Horzl_LngREmph,and S_5_5_InvDfMom.The AUC of the model were 0.987[95％confidence interval(CI)0.965-1.000]and 0.918(95％CI 0.818-1.000)in the training and testing groups,respectively.The sensitivity was 98.7％(95％CI 92.4-100)and 93.9％(95％CI 84.8-100),and the specificity was 97.5％(95％CI 90.0-100)and 88.2％(95％CI 70.6-100),respectively.Conclusion The construction of a predictive model for short-term therapeutic efficacy of HCC after RFA based on texture analysis of preoperative MRI arterial phase images is feasible and demonstrates good predictive performance.