Objective To establish a risk scoring system for aneurysm rupture in patients with moyamoya disease(MMD)and evaluate its predictive efficacy.Methods The clinical data of 191 patients with MMD associated with intracranial aneurysms admitted from October 2019 to October 2023 were retrospectively analyzed.They were randomly divided into a modeling cohort(142 cases)and a validation cohort(49 cases)at a ratio of 7:3.Based on the data of the modeling cohort,a multivariate logistic regression model was used to analyze the risk factors for aneurysm rupture.Then,a predictive scoring system(MMD-aneurysm score)was established based on the β values of the risk factors.The predictive ability was evaluated by ROC curves and compared with the PHASES score,the ELAPSS score,and the Japanese aneurysm score.Results Among the 142 cases in the modeling cohort,51 cases had aneurysm rupture and 91 cases did not;among the 49 cases in the validation cohort,17 cases had aneurysm rupture and 32 cases did not.The multivariate logistic regression analysis indicated that peripheral aneurysm,posterior circulation aneurysm,and large aneurysm were independent risk factors for aneurysm rupture(P<0.05).The MMD-aneurysm score was successfully established based on the results of the multivariate logistic regression analysis.The ROC curve showed that the area under the curve(AUC)for predicting aneurysm rupture was 0.782(95%CI 0.700～0.856),the sensitivity was 0.686,the specificity was 0.780,and the Youden index was 0.466.Its AUC was significantly superior to that of the ELAPSS score,the PHASES score,and the Japanese aneurysm score(P<0.05).Conclusions The MMD-aneurysm score constructed based on three factors,namely peripheral aneurysm,posterior circulation aneurysm,and aneurysm size,has certain predictive value for the rupture risk of intracranial aneurysms in patients with MMD.
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