Correlation between low-dose craniocervical CTA-derived plaque characteristics and the risk of ischemic stroke

YAN Ji-lai; SHI Zhao-chun

doi:10.11659/jjssx.01E026051

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Correlation between low-dose craniocervical CTA-derived plaque characteristics and the risk of ischemic stroke

Clinical Research | 更新时间：2026-10-26

- Correlation between low-dose craniocervical CTA-derived plaque characteristics and the risk of ischemic stroke
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 35, Issue 10, Pages: 896-900(2026)
- 作者机构：
  
  1.南京医科大学第一附属医院放射科，江苏南京 210029
  2.南京医科大学第一附属医院神经内科，江苏南京 210029
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.01E026051
  CLC： R743.3;R814.42
- Received：10 January 2026，
  
  Revised：2026-08-05，
  
  Accepted：14 April 2026，
  
  Published：25 October 2026
- 稿件说明：
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严吉来,史兆春.低剂量颅颈动脉CTA斑块特征与缺血性脑卒中发病风险的相关性研究[J].局解手术学杂志,2026,35(10):896-900.

YAN Ji-lai,SHI Zhao-chun.Correlation between low-dose craniocervical CTA-derived plaque characteristics and the risk of ischemic stroke[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(10):896-900.
严吉来,史兆春.低剂量颅颈动脉CTA斑块特征与缺血性脑卒中发病风险的相关性研究[J].局解手术学杂志,2026,35(10):896-900. DOI： 10.11659/jjssx.01E026051.

YAN Ji-lai,SHI Zhao-chun.Correlation between low-dose craniocervical CTA-derived plaque characteristics and the risk of ischemic stroke[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(10):896-900. DOI： 10.11659/jjssx.01E026051.

摘要

目的

评估低剂量颅颈动脉CT血管造影（CTA）斑块特征与缺血性脑卒中发生风险的相关性。

方法

选取2021年10月至2023年6月在南京医科大学第一附属医院接受低剂量颅颈动脉CTA检查的87例患者为研究对象，根据术后24个月内是否发生缺血性脑卒中分为卒中组（

=23）与非卒中组（

=64）。另选取同期87例在我院接受常规剂量颅颈动脉CTA检查的患者作为辐射剂量对照组。记录2组患者颈动脉斑块的数量、位置、形态、密度及颈动脉狭窄程度，采用多因素Logistic回归分析筛选缺血性脑卒中发生的独立危险因素。

结果

低剂量颅颈动脉CTA图像质量可满足诊断需求，患者接受的有效辐射剂量较常规剂量降低56.2%。卒中组颈动脉斑块数量≥2个、颈动脉分叉处斑块、斑块形态不规则、混合斑块、颈动脉中度及以上狭窄的患者占比高于非卒中组，差异均有统计学意义（

0.05）。多因素Logistic回归分析显示，颈动脉分叉处斑块（

=3.215，95%

：1.102~9.386）、斑块形态不规则（

=2.987，95%

：1.015~8.803）、混合斑块（

=3.524，95%

：1.201~10.345）、颈动脉中度及以上狭窄（

=4.102，95%

：1.387~12.134）是缺血性脑卒中发生的独立危险因素（

0.05）。

结论

低剂量颅颈动脉CTA可在显著降低辐射剂量的前提下，精准评估斑块特征及颈动脉狭窄程度。斑块位于颈动脉分叉处、形态不规则、混合斑块、颈动脉中度及以上狭窄的患者出现缺血性脑卒中的风险增加，可作为临床早期干预的重要参考指标。

Abstract

Objective

To evaluate the correlation between plaque characteristics and the risk of ischemic stroke by low-dose craniocervical computed tomography angiography （CTA）.

Methods

A total of 87 patients who underwent low-dose craniocervical CTA examination in the First Affiliated Hospital of Nanjing Medical University from October 2021 to June 2023 were selected as the research objects.According to the occurrence of ischemic stroke within 24 months after surgery，the patients were divided into the stroke group（

=23） and the non-stroke group （

=64）. Another 87 patients who received conventional-dose craniocarotid a

rtery CTA examination in our hospital during the same period were selected as the radiation dose control group.The number，location，morphology， density of carotid plaques，and the degree of carotid artery stenosis of patients in the two groups were recorded.Multivariate Logistic regression analysis was used to screen the independent risk factors for the occurrence of ischemic stroke.

Results

The image quality of low‑dose craniocervical CTA can meet the diagnostic requirements， and the effective radiation dose received by patients was reduced by 56.2% compared with the conventional dose.The proportions of patients with ≥2 carotid plaques， plaques located at carotid bifurcation， irregular plaque morphology， mixed plaques， and moderate or severe carotid artery stenosis in the stroke group were significantly higher than those in the non-stroke group （

0.05）. Multivariate Logistic regression analysis showed that plaques located at carotid bifurcation （

=3.215，95%

=1.102 to 9.386），irregular plaque morphology （

=2.987，95%

=1.015 to 8.803），mixed plaques（

=3.524，95%

=1.201 to 10.345） and moderate or severe carotid artery stenosis （

=4.102，95%

=1.387 to 12.134） were the independent risk factors for the occurrence of ischemic stroke （

0.05）.

Conclusion

Low-dose craniocervical CTA can accurately evaluate plaque characteristics and the degree of carotid artery stenosis on the premise of significantly reducing radiation dose.Patients with plaques located at carotid bifurcation， irregular plaque morphology， mixed plaques， and moderate or severe carotid stenosis have an increased risk of ischemic stroke， which may serve as important reference indicators for early clinical intervention.

关键词

Keywords

references

中国卒中学会，中国卒中学会神经介入分会，中华预防医学会卒中预防与控制专业委员会介入学组，等 . 急性缺血性卒中血管内治疗中国指南2023 ［J］. 中国卒中杂志， 2023 ， 18 （ 6 ）： 684 - 711 . doi： 10.3969/j.issn.1673-5765.2023.06.010 http://dx.doi.org/10.3969/j.issn.1673-5765.2023.06.010 .

杨海蕾，陈晨，屈秋民 . 社区脑卒中高危人群颈动脉粥样硬化与缺血性脑卒中的关系［J］. 西安交通大学学报（医学版）， 2019 ， 40 （ 6 ）： 916 - 921 . doi： 10.7652/jdyxb201906014 http://dx.doi.org/10.7652/jdyxb201906014 .

吕发金 . 头颈CT血管成像临床应用研究与技术进展［J］. 重庆医科大学学报， 2019 ， 44 （ 10 ）： 1249 - 1253 . doi： 10.13406/j.cnki.cyxb. 002258 http://dx.doi.org/10.13406/j.cnki.cyxb.002258 .

North American Symptomatic Carotid Endarterectomy Trial Colla-borators ， Barnett HJM ， Taylor DW ， et al . Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis ［J］. N Engl J Med ， 1991 ， 325 （ 7 ）： 445 - 453 . doi： 10.1056/NEJM199108153250701 http://dx.doi.org/10.1056/NEJM199108153250701 .

中华医学会神经病学分会，中华医学会神经病学分会脑血管病学组 . 中国急性缺血性卒中诊治指南2023 ［J］. 中华神经科杂志， 2024 ， 57 （ 6 ）： 523 - 559 . doi： 10.3760/cma.j.cn113694-20240410-00221 http://dx.doi.org/10.3760/cma.j.cn113694-20240410-00221 .

Rizvi A ， Seyedsaadat SM ， Alzuabi M ， et al . Carotid plaque vulnerability on magnetic resonance imaging and risk of future ischemic events： a systematic review and meta-analysis ［J］. J Neurosurg Sci ， 2020 ， 64 （ 5 ）： 480 - 486 . doi： 10.23736/S0390-5616.20.04959-0 http://dx.doi.org/10.23736/S0390-5616.20.04959-0 .

吴磊，仝贺，李松，等 . 基于CTA的颈动脉斑块钙化特征与急性缺血性脑卒中风险的相关性研究［J］. 蚌埠医科大学学报， 2025 ， 50 （ 9 ）： 1264 - 1268 . doi： 10.13898/j.cnki.issn.2097-5252.2025. 09.015 http://dx.doi.org/10.13898/j.cnki.issn.2097-5252.2025.09.015 .

张玉芳 . 颈动脉超声评估颈动脉粥样硬化斑块易损性的临床应用研究［J］. 内蒙古医学杂志， 2016 ， 48 （ 4 ）： 410 - 412 . doi： 10.16096/J.cnki.nmgyxzz.2016.48.04.010 http://dx.doi.org/10.16096/J.cnki.nmgyxzz.2016.48.04.010 .

Chrencik MT ， Khan AA ， Luther L ， et al . Quantitative assessment of carotid plaque morphology （geometry and tissue composition） using computed tomography angiography ［J］. J Vasc Surg ， 2019 ， 70 （ 3 ）： 858 - 868 . doi： 10.1016/j.jvs.2018.11.050 http://dx.doi.org/10.1016/j.jvs.2018.11.050 .

Pakizer D ， Kozel J ， Elmers J ， et al . Carotid plaque characteristics by computed tomography： a diagnostic accuracy systematic review ［J］. Int J Cardiol Heart Vasc ， 2025 ， 58 ： 101656 . doi： 10.1016/j.ijcha. 2025.101656 http://dx.doi.org/10.1016/j.ijcha.2025.101656 .

Saba L ， Sanfilippo R ， di Martino M ， et al . Volumetric analysis of carotid plaque components and cerebral microbleeds： a correlative study ［J］. J Stroke Cerebrovasc Dis ， 2017 ， 26 （ 3 ）： 552 - 558 . doi： 10.1016/j.jstrokecerebrovasdis.2016.11.123 http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2016.11.123 .

Aizaz M ， Bierens J ， Gijbels MJJ ， et al . Differentiation of atherosclerotic carotid plaque components with dual-energy computed tomography ［J］. Invest Radiol ， 2025 ， 60 （ 8 ）： 508 - 516 . doi： 10.1097/RLI.00000 00000001153 http://dx.doi.org/10.1097/RLI.0000000000001153 .

Arasu R ， Arasu A ， Muller J . Carotid artery stenosis：an approach to its diagnosis and management ［J］. Aust J Gen Pract ， 2021 ， 50 （ 11 ）： 821 - 825 . doi： 10.31128/AJGP-10-20-5664 http://dx.doi.org/10.31128/AJGP-10-20-5664 .

Kosmopoulos M ， Rojas-Salvador C ， Koukousaki D ， et al . The link between carotid artery stenosis and outcomes in patients with refractory out-of-hospital cardiac arrest ［J］. Resuscitation ， 2024 ， 201 ： 110289 . doi： 10.1016/j.resuscitation.2024.110289 http://dx.doi.org/10.1016/j.resuscitation.2024.110289 .

Saba L ， Saam T ， Jäger HR ， et al . Imaging biomarkers of vulnerable carotid plaques for stroke risk prediction and their potential clinical implications ［J］. Lancet Neurol ， 2019 ， 18 （ 6 ）： 559 - 572 . doi： 10.1016/S1474-4422（19）30035-3 http://dx.doi.org/10.1016/S1474-4422（19）30035-3 .

中华医学会放射学分会头颈放射学组 . 头颈部CT血管成像扫描方案与注射方案专家共识［J］. 中华放射学杂志， 2019 ， 53 （ 5 ）： 348 - 353 . doi： 10.3760/cma.j.issn.1005-1201.2019.05.003 http://dx.doi.org/10.3760/cma.j.issn.1005-1201.2019.05.003 .

王碧昊 . CTA与MRI评估无症状性颈动脉狭窄及其临床关联［J］. CT理论与应用研究， 2019 ， 28 （ 6 ）： 763 - 769 . doi： 10.15953/j.1004-4140.2019.28.06.10 http://dx.doi.org/10.15953/j.1004-4140.2019.28.06.10 .

Brinjikji W ， 3rd Huston J ， Rabinstein AA ， et al . Contemporary carotid imaging： from degree of stenosis to plaque vulnerability ［J］. J Neurosurg ， 2016 ， 124 （ 1 ）： 27 - 42 . doi： 10.3171/2015.1.jns142452 http://dx.doi.org/10.3171/2015.1.jns142452 .

Baradaran H ， Foster T ， Harrie P ， et al . Carotid artery plaque characteristics：current reporting practices on CT angiography ［J］. Neuroradiology ， 2021 ， 63 （ 7 ）： 1013 - 1018 . doi： 10.1007/s00234-020-02610-w http://dx.doi.org/10.1007/s00234-020-02610-w .

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