Acute stroke risk prediction model based on dual-energy CTA-derived carotid plaque, perivascular adipose tissue characteristics, and serum lipid parameters: a dual-center study.

IF 2.6 3区 医学 Q2 CLINICAL NEUROLOGY
He Zhang, Xu Xu, Juan Long, Chenzi Wang, Xiaohan Liu, Wenbei Xu, Xiaonan Sun, Peipei Dou, Dexing Zhou, Wei Cao, Kai Xu, Yankai Meng
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Abstract

Background: Acute stroke is a major global cause of mortality and disability. Accurate prediction of stroke risk is crucial for effective clinical management. This study aimed to develop a multidimensional prediction model for acute stroke using carotid plaque characteristics, lumen parameters, perivascular adipose tissue (PVAT) quantitative metrics derived from dual-energy computed tomography angiography (DE-CTA), and serum lipid biomarkers.

Methods: This retrospective dual-center study enrolled 212 patients who underwent DE-CTA and MRI between January 2023 and October 2024, comprising a training cohort (137 patients) and an external validation cohort (75 patients). Quantitative parameters including carotid plaque features (composition and intraplaque parameters), lumen metrics, PVAT quantitative indices, and serum lipid levels were collected. Patients with ipsilateral acute anterior circulation infarcts identified on MRI were classified as symptomatic (STA), and those without infarcts as asymptomatic (ATA). Variables were selected via univariate analysis and LASSO regression to construct a multivariate logistic regression model. Model performance was evaluated by ROC analysis, confusion matrix, calibration curves, and clinical decision curves, followed by external validation.

Results: External validation of the final model showed an area under the ROC curve (AUC) of 0.810, with a sensitivity of 80.8% and specificity of 65.3%, indicating robust predictive performance and good clinical applicability.

Conclusions: The multidimensional predictive model integrating DE-CTA-derived carotid plaque features, PVAT metrics, and serum lipid parameters effectively predicts acute stroke risk, providing a reliable quantitative tool for early screening and clinical intervention.

基于双能cta衍生颈动脉斑块、血管周围脂肪组织特征和血脂参数的急性卒中风险预测模型:一项双中心研究
背景:急性脑卒中是全球死亡和残疾的主要原因。准确预测脑卒中风险对有效的临床管理至关重要。本研究旨在利用颈动脉斑块特征、管腔参数、双能计算机断层血管造影(DE-CTA)得出的血管周围脂肪组织(PVAT)定量指标和血清脂质生物标志物,建立急性卒中的多维预测模型。方法:这项回顾性双中心研究纳入了2023年1月至2024年10月期间接受DE-CTA和MRI检查的212例患者,包括培训队列(137例)和外部验证队列(75例)。定量参数包括颈动脉斑块特征(组成和斑块内参数)、管腔指标、PVAT定量指标和血脂水平。MRI发现的同侧急性前循环梗死患者分为有症状性(STA),无梗死者分为无症状性(ATA)。通过单因素分析和LASSO回归选取变量,构建多元logistic回归模型。采用ROC分析、混淆矩阵、校准曲线和临床决策曲线评价模型性能,并进行外部验证。结果:最终模型经外部验证,ROC曲线下面积(AUC)为0.810,敏感性为80.8%,特异性为65.3%,预测效果稳健,具有较好的临床适用性。结论:综合de - cta衍生颈动脉斑块特征、PVAT指标和血脂参数的多维预测模型可有效预测急性卒中风险,为早期筛查和临床干预提供可靠的定量工具。
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来源期刊
Neuroradiology
Neuroradiology 医学-核医学
CiteScore
5.30
自引率
3.60%
发文量
214
审稿时长
4-8 weeks
期刊介绍: Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.
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