ORIGINAL RESEARCH article
Front. Neurol.
Sec. Applied Neuroimaging
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1628353
Association between carotid plaque calcification and clinical outcomes of symptomatic cerebral small vessel disease
Provisionally accepted
- 1Shandong First Medical University, Jinan, China
- 2Shandong Provincial Hospital, Jinan, China
- 3Liaocheng People’s Hospital, Liaocheng, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: 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. Methods: 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. Results: 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 (p = 0.001). Logistic regression found 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 p < 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, p < 0.001). Conclusion: Carotid calcification characteristics were associated with clinical outcomes of symptomatic CSVD, which could be used as predictive indicators of CSVD outcomes.
Keywords: Atherosclerosis, calcification, Cerebral small vessel disease, clinical outcomes, computed tomography angiography
Received: 14 May 2025; Accepted: 25 Jul 2025.
Copyright: © 2025 Zhang, Zhao, Hou, Wang, Guo and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yunliang Guo, Shandong Provincial Hospital, Jinan, China
Ximing Wang, Shandong Provincial Hospital, Jinan, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.