Zhang Jing, Zhao Shuo, Hou Xunyao, Wang Xinyao, Guo Yunliang, Wang Ximing
School of Medicine, Shandong First Medical University, Jinan, China.
Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
Front Neurol. 2025 Aug 14;16:1628353. doi: 10.3389/fneur.2025.1628353. eCollection 2025.
Atherosclerosis is the most common pathological change of cerebral small vessel disease (CSVD). This study aimed to investigate correlations between carotid atherosclerotic calcification and clinical outcomes of symptomatic CSVD.
We retrospectively evaluated 210 symptomatic CSVD patients who underwent carotid computed tomography angiography (CTA) and brain magnetic resonance imaging (MRI). Clinical outcomes were evaluated using modified Rankin Scale (mRS) at 90 days after acute event. The presence and characteristics of carotid calcification (including size, number and location), carotid plaque burden and CSVD markers were analyzed. Logistic regression analysis was used to explore associations between carotid calcification and CSVD outcomes. Key confounding variables (age, sex, hypertension, diabetes mellitus, hyperlipidemia, coronary heart disease, smoking history, drinking history, ulceration, positive remodeling and positive soft plaque) were adjusted in multivariate analysis. The areas under the curve (AUC) of receiver operating characteristic (ROC) curves were used to analyze predictive performance of various radiological variables for CSVD outcomes.
A total of 129 patients with poor outcomes and 81 with good outcomes were analyzed. The incidence of calcification plaque in poor outcome group was higher than those in good outcome group ( = 0.001). Logistic regression found that the presence of calcification, surface calcification, multiple calcifications, thick/mixed calcifications, carotid stenosis degree and total CSVD score were associated with adverse outcomes in symptomatic CSVD before and after adjusting for confounding factors (all < 0.05). ROC analysis showed that the prediction model with integrated carotid calcification exhibited enhanced performance with a sensitivity of 75.19% and specificity of 70.37% (AUC = 0.752, < 0.001).
Carotid calcification characteristics were associated with clinical outcomes of symptomatic CSVD, which could be used as predictive indicators of CSVD outcomes.
动脉粥样硬化是脑小血管病（CSVD）最常见的病理改变。本研究旨在探讨颈动脉粥样硬化钙化与有症状CSVD临床结局之间的相关性。
我们回顾性评估了210例接受颈动脉计算机断层扫描血管造影（CTA）和脑磁共振成像（MRI）的有症状CSVD患者。在急性事件发生90天后，使用改良Rankin量表（mRS）评估临床结局。分析颈动脉钙化的存在情况及特征（包括大小、数量和位置）、颈动脉斑块负荷和CSVD标志物。采用逻辑回归分析探讨颈动脉钙化与CSVD结局之间的关联。在多变量分析中对关键混杂变量（年龄、性别、高血压、糖尿病、高脂血症、冠心病、吸烟史、饮酒史、溃疡、阳性重塑和阳性软斑块）进行了校正。采用受试者操作特征（ROC）曲线下面积（AUC）分析各种放射学变量对CSVD结局的预测性能。
共分析了129例预后不良患者和81例预后良好患者。预后不良组钙化斑块的发生率高于预后良好组（=0.001）。逻辑回归发现，在调整混杂因素前后，钙化的存在、表面钙化、多发钙化、厚/混合钙化、颈动脉狭窄程度和总CSVD评分与有症状CSVD的不良结局相关（均<0.05）。ROC分析显示，整合颈动脉钙化的预测模型性能增强，敏感性为75.19%，特异性为70.37%（AUC=0.752，<0.001）。
颈动脉钙化特征与有症状CSVD的临床结局相关，可作为CSVD结局的预测指标。
