Evidence map›Paper›PMID 41904261›Full record

ArticleEuropean radiology2026

Plaque-level comparison of carotid CTA and high-resolution magnetic resonance vessel wall imaging for assessing MRI-defined plaque vulnerability.

Juan Long, Xiaohan Liu, He Zhang, Zhen Wang, He Zhang, Zhongxiao Liu, Aiyun Sun, Yankai Meng, Kai Xu

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in European radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Juan Long *Department of Radiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
Xiaohan Liu *Department of Radiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
He Zhang *Department of Radiology, Jiawang District People's Hospital, Xuzhou, China.
Zhen WangDepartment of Radiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
He ZhangDepartment of Radiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
Zhongxiao LiuDepartment of Radiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
Aiyun SunCT Imaging Research Center, GE HealthCare China, Shanghai, China.
Yankai MengDepartment of Radiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China. mengyankai@126.com.ORCID http://orcid.org/0000-0002-9671-538X
Kai XuDepartment of Radiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.

Funding

the Affiliated Hospital of Xuzhou Medical University Institutional Research Project 2024ZY08the Key Research and Development Program of Xuzhou Science and Technology Bureau KC23279Xuzhou Health Commission Technology Projects XWKYHT20240086
6 · The paper itself

Abstract

objectivesTo evaluate carotid computed tomography angiography (CTA) performance in assessing MRI-defined plaque vulnerability using high-resolution magnetic resonance vessel wall imaging (HR-MR-VWI) as the reference, and to develop a multidimensional predictive model integrating plaque composition, geometry, and perivascular adipose tissue (PVAT). MATERIALS AND

methodsPatients undergoing both CTA and HR-MR-VWI were retrospectively included. Plaques were classified by modified AHA criteria and co-registered to ensure spatial correspondence. Quantitative CTA features were extracted via semi-automated segmentation. A historical cohort (2018-2024) was partitioned into training (n = 130) and internal validation (n = 57) sets; a recent cohort (2024-2025) served as a prospective temporal test set (n = 78). A multivariate logistic regression model was developed and evaluated using the area under the receiver operating characteristic curve (AUC) and decision curve analysis.

resultsIn 265 plaques, PVAT attenuation (OR = 1.05; p < 0.001) and maximum diameter stenosis (MDS) (OR = 1.03; p < 0.05) emerged as independent predictors of MRI-defined vulnerability. The combined model achieved robust discrimination with AUCs of 0.86, 0.80, and 0.85 in the training, internal validation, and prospective temporal test sets, respectively. Calibration and decision curve analysis demonstrated excellent agreement and clinical net benefit across all cohorts.

conclusionCTA-derived MDS and PVAT attenuation are robust independent predictors of MRI-defined carotid plaque vulnerability. This supportive, proof-of-concept nomogram offers a tool for characterizing high-risk plaque phenotypes, highlighting CTA as a viable supplementary tool to MRI in routine practice. KEY POINTS: Question Can a multidimensional carotid CTA model, integrating perivascular adipose tissue and luminal geometry, accurately identify high-risk plaque phenotypes compared to high-resolution MRI? Findings CTA-derived perivascular fat attenuation and stenosis severity are independent predictors of MRI-defined plaque vulnerability, achieving robust diagnostic performance across internal and temporal validation. Clinical relevance This plaque-level CTA model provides a rapid, accessible tool for identifying MRI-defined vulnerable carotid plaques and personalized management in routine clinical practice where MRI access is limited.

Indexed as

Carotid ArteriesCarotid Artery DiseasesComputed Tomography AngiographyMagnetic Resonance AngiographyMagnetic Resonance ImagingPlaque, AtheroscleroticAgedFemaleHumansMaleMiddle AgedRetrospective StudiesAdipose tissueCarotid arteriesComputed tomography angiographyMagnetic resonance imagingPlaque (atherosclerotic)

Identifiers

PMID41904261

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.