Feasibility of low-dose carotid CT angiography (CTA) for quantitative carotid plaque evaluation.

Computational fluid dynamics (CFD)-based numerical calculation of fractional flow reserve (FFRCT) and instantaneous wave-free ratio (iFRCT) is a crucial non-invasive technology for assessing myocardial ischemia. Their diagnostic accuracy depends on precisely calculating epicardial coronary stenosis resistance and coronary microcirculatory resistance. However, conventional CFD models face two main limitations. First, they assume rigid vessel walls, failing to capture how different plaque types affect stenosis resistance through neural regulation-induced vasodilation changes. Second, the presence of compensatory mechanisms in coronary microcirculation leads to inaccuracies in calculating microcirculatory resistance. These physiological oversimplifications, combined with the low computational efficiency of traditional CFD, compromise diagnostic accuracy and hinder real-time clinical application. This paper systematically reviews existing FFRCT/iFRCT computational models, their limitations, and current research on model improvement and computational efficiency. Given the acute nature and high mortality of myocardial infarction, future efforts should focus on establishing high-fidelity cardiovascular simulation models by integrating multi-modal clinical data. Combining artificial intelligence with digital twin technology could enable dynamic early warning for acute myocardial ischemia and infarction in daily life applications. This direction represents a promising future development path for non-invasive diagnostic technologies and holds significant clinical value.

Is there a relationship between extracardiac pulmonary findings and coronary artery stenosis severity and plaque types?

Coronary computed tomography angiography (CCTA) evaluation of ramus intermedius and left coronary atherosclerosis: presence, distribution, and plaque characteristics.

Proteomics and ex vivo plaque culture identify the insulin-like growth factor axis as a potential regulator of matrix remodelling in carotid plaques.

PurposeTo develop and benchmark eye plaque models for Monte Carlo (MC) simulation of iris melanoma brachytherapy and to develop a database of 3D dose distributions for the iris plaques containing , , and seeds.Acquisition and Validation MethodsFive iris plaque models are developed with egs_brachy using published dimensions and material data; previously benchmarked seed models are used. Three plaque models are based on those used by the Mayo Clinic, consisting of a modification of the COMS 22 mm plaque design with a 10 mm void in the center surrounded by an inner collimating lip; plaques span 180∘, 270∘, and 360∘ arcs. Two additional plaques are modeled: a modified Iris‐270 plaque with no collimating lips; a partially‐loaded COMS 22 mm plaque with no insert. Plaques are simulated in a water phantom with dose scored in (0.05 cm)3 voxels. Simulations under TG‐43 conditions are also carried out. Doses are compared to previously published data for validation.Data Format and Usage NotesThe eye plaque models will be distributed with egs_brachy on GitHub (https://github.com/clrp‐code/egs_brachy), along with an input file to facilitate custom simulations. The dosimetric database (https://doi.org/10.5281/zenodo.14776641) is comprised of 3D dose distributions for each plaque type, simulation condition, and radionuclides.Potential applicationsThe iris plaque models enable custom simulations with the open‐access egs_brachy code. The database of 3D dose distributions supports advanced dose evaluations, as recommended by AAPM Task Group 221 on Ocular Brachytherapy. Overall, this work supports adoption of model‐based dose evaluations for brachytherapy as recommended by TG‐186.

This article is devoted to a comprehensive analysis of the belt accessories worn by Turkic warriors in the Eurasian steppes in the 5th-15th centuries. Based on a summary of some of the archaeological materials discovered in local cultural and historical areas (Altai, Eastern Kazakhstan, Zhetysu, Volga-Ural, Caspian Sea region, and North Caucasus), the article examines the main typological, structural, and ornamental characteristics of the belt sets worn by Turkic warriors. The article attempts to systematize the main morphological types of buckles, plaques, pendants, and belt details, identifying five chronologically related horizons in the development of belt sets. Particular attention is paid to issues of ethnocultural attribution, cross-cultural influences between Turkic, Chinese, Sogdian, and Iranian-Caucasian craft traditions, and the social semantics of belts, which have made it possible to reconstruct social stratification and symbolic functions among Turkic warriors. The study reveals the social status semantics of belts as markers of power, as well as belonging to the military elite and clan identity. The work aims to create a unified scientific basis for subsequent metallographic, typological-statistical, and source studies. The aim of the study is to comprehensively compile and scientifically analyze materials on the belt sets of Turkic warriors of the 5th-15th centuries in order to identify the main typological groups, chronological horizons, and social status functions, as well as to analyze the cross-cultural influences of certain elements of the belt set. The following methods were used in the study: technological analysis allows us to determine the thickness of the metal, the nature of the casting, traces of tools, the use of various techniques (e.g., cloisonné enamel, embossing, inlay, granulation, etc.) characteristic of certain regional craft centers, and “imported” influences—casting, stamping, embossing, cloisonné enamel, and inlay; The comparative-historical method helps to compare Turkic toreutics with Chinese analogues, Sogdian belt sets, Iranian and Caucasian samples, which allows us to clarify the origin and chronology of hand-relief processing of metal artworks, revealing cultural contacts and the degree of influence of other cultures; Semiotic analysis of ornamentation made it possible to study the symbolism of animal styles, heraldic motifs, and national mythological images of belt set elements, revealing the ideological and status components of its owner and other methods.

Objective This study was designed to test if multidetector computed tomography-derived epicardial fat parameters like epicardial fat volume, thickness, and attenuation can predict obstructive coronary artery disease in a South Indian Population. Methods All 60 patients underwent a coronary angiogram using 128-slice multidetector computed tomography. Computed tomography coronary angiogram studies were evaluated for coronary artery calcium score, presence of plaque, type of plaque, epicardial fat volume, and degree of coronary stenosis. Results 60 patients had a mean age of 51.7 ± 11.4 years. Obstructive coronary artery disease (≥50% luminal narrowing) was found in 91.7% of males. Various risk factors for coronary artery disease were diabetes mellitus (40%), hypertension (55%), hyperlipidemia (58.33%), smoking (15%), and body mass index >25 (41.67%). These risk factors were higher in the “obstructive coronary artery disease” group than in the “no/non-obstructive coronary artery disease” group, with a statistically significant correlation. Mean epicardial fat volume for the studied population was found to be 114.26 ± 45.68 cm 3 with values ranging from 38.55 cm 3 to 270.08 cm 3 . The mean epicardial fat volume of “obstructive coronary artery disease” group was found to be higher, that is, 137.69 ± 29.44 cm 3 compared to “no/non-obstructive coronary artery disease” group, which was 108.4 ± 47 cm 3 , showing a statistically significant correlation ( P = .046). Multiple variables showed a positive correlation of epicardial fat volume with the increasing degree of coronary artery stenosis. Epicardial fat volume demonstrated a statistically significant correlation with age ( P = .007), hypertension ( P = .001), hyperlipidemia ( P = .034), smoking ( P = .002), and body mass index ( P < .001). Epicardial fat volume also showed a statistically significant correlation with the epicardial mesenteric fat area ( P < .001), calcium score ( P = .048), and epicardial fat thickness ( P < .001). An increase in epicardial fat volume was observed with higher calcium score categories, showing a statistically significant correlation ( P = .02). Based on the receiver operating characteristic curve, an optimal cutoff value of >110.48 cm 3 was obtained, which shows a sensitivity and specificity of 91.67% and 60.42%, respectively. Epicardial fat volume (multidetector computed tomography) is a significant imaging biomarker for predicting obstructive coronary artery disease with a cutoff value of >110.48 cm³ for differentiating.

Ruthenium-106 (Ru-106) plaque brachytherapy is an established treatment modality for choroidal melanoma that delivers localized beta radiation while sparing surrounding ocular structures. It is widely used in Europe and parts of Asia, whereas COMS Iodine-125 and Palladium-103 plaques remain the standard in the United States. However, its concave geometry presents challenges for accurate dose verification, as conventional flat dosimeters are ill-suited for use during commissioning and quality assurance (QA). This study aimed to assess the feasibility and dosimetric accuracy of a plaque-adaptive flexible film dosimeter (PFD) for planar and central axis (CAX) dose measurements in Ru-106 plaque brachytherapy. The PFD consisted of an active layer of lithium salt of pentacosa-10,12-diynoic acid (LiPCDA) enclosed between upper and lower silicone sheets. The flexible film was shaped to conform to the curvature of the Ru-106 plaques and mounted within a dual-layer film holder. A 3D-printed QA tool was used for reproducible positioning. Dose measurements were performed at depths of 1 and 3mm for CCA, COB, and CIB plaque types using a dual-film configuration. Planar dose distributions were assessed at 33 manufacturer-certified reference points at a 1mm depth. CAX dose profiles were independently acquired using a microDiamond detector in a water phantom. All measurements were compared with manufacturer-certified reference data. Calibration curves were established based on optical density and dose uncertainties were analyzed. The dose ratio between 1 and 3mm depths measured with the PFD differed by -0.2% to 0.4% from the reference data across all plaque types. Planar dose measurements at 33 points yielded a mean difference of 3.0%±2.0% from reference values. In the high-dose central region, the mean differences for CCA, COB, and CIB were 2.1%±0.8%, 2.1%±0.8%, and 2.2%±0.7%, respectively. CAX dose profiles measured with a microDiamond detector differed by 0.89%±0.58%. Total dose uncertainty ranged from 4.43% at 0.3Gy to 4.19% at 2.4Gy. The PFD enabled accurate and high-resolution dose measurements on the curved surfaces of Ru-106 plaques. Both planar and CAX measurements demonstrated strong agreement with manufacturer-certified reference data across all plaque types. This system offers a practical and reproducible solution for commissioning and QA in Ru-106 plaque brachytherapy, supporting its clinical integration for choroidal melanoma treatment.

ABSTRACT Clinicopathologically, dura mater graft-associated Creutzfeldt-Jakob disease (dCJD) presents as either a non-plaque or plaque type. Here, we report an autopsy case of plaque-type dCJD, supported by genetic and biochemical analyses. A 41-year-old man manifested right-hand paraesthesia. He had received a dural graft in the right parietal region following a traumatic acute subdural haematoma 27 years before symptom onset. The clinical course was slowly progressive. The patient became unable to walk independently 17 months after onset, showed cognitive decline at 22 months, and developed myoclonus and akinetic mutism at 24 months. Periodic sharp-wave complexes were never observed on electroencephalography throughout the disease course. He died 26 months after symptom onset. No mutations were identified in the prion protein (PrP) gene, and the codon 129 polymorphism was homozygous for methionine. Neuropathologically, mild to moderate spongiform changes with fine vacuoles, neuronal loss, and astrogliosis were observed in the brain and spinal cord. Degeneration was relatively severe in the limbic system, striatum, thalamus, and cerebellum, resembling the distribution pattern of VV2 sporadic CJD. Abnormal PrP deposition was broadly distributed consisting of synaptic, perineuronal, and plaque forms. In particular, intense PrP staining was observed throughout the spinal grey matter. Western blotting detected intermediate-type PrP in the brain and cervical cord, but not in systemic organs. Considering the clinical course and PrP staining in the spinal cord, PrP transmission is suggested to occur not directly from the transplanted dura mater to the central nervous system, but rather indirectly via a peripheral route.

Objective: To determine the prevalence, distribution pattern, and characteristics of atherosclerotic plaques in major coronary arterial segments using Computed Tomography Coronary Angiography (CCTA) in a tertiary care setting. Methods: A descriptive cross-sectional study was conducted at Rehman Medical Institute, Peshawar, involving 285 patients undergoing CCTA for suspected coronary artery disease (CAD). Angiographic images were analysed to identify plaque location (Left Anterior Descending [LAD], Right Coronary Artery [RCA], Left Circumflex [LCx]), segmental distribution (proximal, middle, distal), plaque type (calcified, non-calcified, mixed), and degree of stenosis. Data were analysed using SPSS. Results: The majority of patients were male (67.7%) with a peak age prevalence between 46–55 years (34.7%). The Left Anterior Descending (LAD) artery was the most affected vessel (62.1%), followed by the RCA (37.2%). Segmental analysis revealed that plaques were predominantly located in the proximal segments of both the LAD (68.9%) and RCA (59.2%). Calcified plaques were the most common type (58.0%), followed by mixed (22.6%) and non-calcified plaques (19.4%). Regarding severity, 21.4% of patients exhibited severe stenosis (>70%), while 42.5% showed no significant stenosis. Conclusion: Atherosclerosis in this population predominantly affects the proximal segment of the LAD artery. Calcified plaques are the most common morphology. These findings highlight the need for targeted screening and early intervention in middle-aged males in this region.

The degradation of alpine meadows on the Qinghai–Tibet Plateau has seriously affected the structure and productivity of grassland communities. In this experiment, a sample area was set up in Keqihetan of Zexiong Village, Youganning Town, Henan County, Mongolian Autonomous Prefecture. The degraded alpine meadow was divided into three plaque types, bare patches (BP), short-term recovered patches (SRP), and long-term recovered patches (LRP), and Native alpine meadows (NM) as controls, in order to reveal the effects of grassland degradation on community structure and aboveground/belowground biomass allocation in alpine meadow. Here, we measured total biomass (TCB), aboveground biomass (AGB), belowground biomass (BGB), and root/shoot ratio (R/S) of alpine meadows on the Qinghai–Tibetan Plateau and investigated plant community cover and height. The results showed that with the restoration of the patchy alpine meadow, the height decreased first and then increased, the amount of AGB increased first and then decreased, while the coverage and BGB increased in turn, and BGB decreased with the deepening of soil depth. We also found that R/S decreased first and then increased with the patch recovery of the alpine meadow. The overall distribution of AGB and BGB belongs to allometric growth distribution, but the native meadow belongs to isometric growth distribution, while other recovery stages belong to allometric growth distribution. By studying the biomass and its distribution of degraded grassland, we can understand the impact of grassland degradation on the community structure and productivity of the alpine meadow.

Abstract The perivascular fat attenuation has emerged as a novel imaging biomarker of coronary artery inflammation in recent years. The present study assessed the role of lesion-specific perivascular fat attenuation (l-PVFA) and vessel-to-l-PVFA ratio (v/l- PVFAR) in plaque characterization and identifying the vulnerable/high risk plaques (HRPs) using computed tomography (CT) coronary angiogram. (1) To establish the significance of l-PVFA and v/l- PVFAR in the characterization of different types of plaques. (2) v/l PVFAR as a new imaging marker in the identification of HRPs. Thirty participants underwent CT coronary angiogram and we studied 70 diseased coronary arteries in these patients. Out of the 70 plaques studied retrospectively, 40 were calcified, 23 were partially calcified, and 7 were noncalcified plaques. l-PVFA and v/l PVFAR were calculated manually for different types of plaques and found significantly higher in noncalcified and partially calcified plaques, when compared with calcified plaques (p < 0.001). v/l PVFAR of > 2 is highly sensitive (100%) and specific (95.2%) for HRP with the diagnostic accuracy of 96.67%. l-PVFA and v/l PVFAR highly correlate with various types of plaques. v/l- PVFAR is a useful biomarker in the identification of HRPs.

Dysfunctional mitochondria increase oxidative stress and inflammation, driving atherosclerosis. Understanding gene expression and regulatory mechanisms is crucial. This study aims to identify key mitochondrial dysfunction-related genes (MitoDEGs) associated with atherosclerotic plaque severity, elucidate their molecular mechanisms and immune-regulatory roles in disease progression, and validate pivotal biomarkers to provide mechanistic insights for personalized therapeutic strategies. We utilized eight atherosclerotic plaque datasets (human samples) from GEO and mitochondrial gene data from MitoCarta3.0. Lasso Regression and the Shap algorithm were employed to identify key differentially expressed mitochondrial genes (MitoDEGs) for model construction. Enriched pathways were analyzed using GO and KEGG databases, and protein–protein interactions were explored with STRING and Cytoscape. Experimental validation was conducted using atherosclerosis mouse models and HUVEC cell models. This study identified distinct and shared mitochondrial dysfunction-related genes (MitoDEGs) in carotid and peripheral atherosclerotic plaques. Key carotid-specific MitoDEGs included HK3 and BID, while peripheral-specific ones included RAC2 and TCL1A. Two common MitoDEGs, GZMB and PMAIP1, were found in both plaque types. Enrichment analyses revealed novel associations with mitochondrial pathways including apoptosis, p53 signaling, hexose metabolism, and protein serine/threonine kinase regulation. Importantly, these MitoDEGs are mechanistically linked to mitochondrial outer membrane integrity and metabolic reprogramming. Experimental validation confirmed the upregulation of core MitoDEGs (CASP1, BID, PMAIP1, and GZMB), highlighting their critical roles in mitochondrial dysfunction during atherosclerosis progression. This study underscores the critical role of mitochondrial dysfunction, mediated by specific MitoDEGs, in atherosclerosis progression. The identified genes modulate both mitochondrial apoptotic pathways and immune cell infiltration, contributing to plaque severity. These shared and location-specific MitoDEGs offer novel mechanistic insights and represent potential therapeutic targets for intervening in plaque development and achieving personalized management of atherosclerotic disease.

Carotid plaque classification based on ultrasound echogenicity and quantification of plaque burden are crucial in stroke risk assessment. In this work, we propose a framework that leverages the synergy between classification and segmentation by sharing plaque location information to enhance the performance of both tasks. Our cascaded framework integrates a ResNet-based classifier (Masked-ResNet-DS) with MedSAM, a medically adapted version of the Segment Anything Model for joint classification and segmentation of carotid plaques from 2D ultrasound images. Ground truth boundaries are used to guide region-specific feature pooling in the classifier, helping it focus on plaques during training. Since ground truth boundaries are unavailable at inference, we introduce a two-iteration strategy: the first generates a class activation map (CAM), which is then used for focused pooling in the second iteration to predict plaque type. The CAM is also used as a prompt to guide MedSAM for segmentation. To ensure accurate localization, the CAM is supervised during training using a Dice loss against the segmentation ground truth. Masked-ResNet-DS achieves a mean F1-score of 96.7% in plaque classification, at least 3.2% higher than competing methods. Ablation studies confirm that ground truth-based pooling and CAM supervision both improve classification. CAM-guided MedSAM achieves a Dice similarity coefficient (DSC) of 86.6%, outperforming U-Net and nnU-Net by 5.9% and 3.6%, respectively. In addition, CAM prompts improve MedSAM's DSC by 2.2%. By sharing plaque location between classification and segmentation, the proposed method improves both tasks and provides a more accurate tool for stroke risk stratification.

To evaluate the intra- and inter-grader concordance of anterior segment optical coherence tomography (ASOCT) grading for detection of endothelial plaque in microbial keratitis, and to compare endothelial plaque detection via ASOCT grading versus in-person slit lamp examination. Diagnostic concordance study of 150 consecutive patients with microbiologically confirmed bacterial or fungal keratitis at a high-volume tertiary eye hospital in India. Two masked ophthalmologist graders independently evaluated ASOCT images for presence of two morphologically distinct endothelial plaque subtypes noted during image review (round and flat plaques). We assessed intra-grader and inter-grader concordance for each endothelial plaque morphology and for presence of either morphology. Diagnostic agreement between ASOCT and in-person slit lamp examination was evaluated using percent agreement, Cohen's kappa, sensitivity, and specificity. Univariable and multivariable logistic regression was used to assess odds of disagreement between ASOCT and slit lamp examination for endothelial plaque detection. ASOCT detection showed near perfect inter-grader agreement for round endothelial plaques (kappa 0.88, 94.7% agreement), flat endothelial plaques (kappa 0.84, 92.0% agreement), and either plaque (kappa 0.88, 94.0% agreement). Intra-grader agreement was substantial to near perfect for both graders across all plaque types (kappa 0.70-0.86). Ophthalmologist slit lamp examination identified endothelial plaque in 6.0% eyes, while ASOCT detected round plaques in 32.7%, flat plaques in 43.3%, and either plaque in 55.3% of eyes. Using ASOCT as reference, slit lamp examination demonstrated sensitivity of 16.3% for round plaques, 6.2% for flat plaques, and 9.6% for either plaque, with specificity exceeding 94% for all. Poor visual acuity (logMAR ≥1.0) was associated with increased disagreement for round plaques (adjusted OR 5.04), flat plaques (adjusted OR 3.63), and either plaque (adjusted OR 3.98). Bacterial infection was associated with increased disagreement for any endothelial plaque (adjusted OR 4.56). Slit lamp examination substantially under-detects endothelial plaque compared to ASOCT, while ASOCT enables reproducible detection with excellent intra- and inter-grader agreement. These findings support incorporation of ASOCT imaging into microbial keratitis evaluation protocols. Differences in round and flat endothelial plaque morphologies warrant further investigation.

Background: Psoriasis is a chronic inflammatory skin disease. Clinical manifestation with arterial stiffness (AS), atherosclerosis, metabolic syndrome, and cardiovascular diseases are common in psoriasis. Objective: To compare AS evaluated by cardio-ankle vascular index (CAVI), clinical and laboratory cardiovascular parameters between psoriasis and non-psoriasis subjects. Materials and Methods: A prospective, observational, analytic study enrolled 26 plaque psoriasis and 104 non-psoriasis participants as the controls, for a one-to-four ratio, at Mae Fah Luang Hospital, Bangkok, Thailand. AS measured by CAVI, clinical, and laboratory evaluation for cardiovascular risk factors were measured and determined between the two groups. Results: The prevalent rate of arterials stiffness or CAVI greater than 8.0 in plaque psoriasis group was 73.1%, which is significantly higher than non-psoriasis subjects of 20.2% (p<0.001). Furthermore, those patients with psoriasis had a significantly higher percentage of those aged older than 40, fasting glucose greater than 100 mg/dL, triglyceride greater than 150 mg/dL, and LDL-cholesterol greater than 130 mg/dL than non-psoriasis group (p<0.05). Nevertheless, CAVI greater than 8.0 or AS was an only independent factor associated with plaque psoriasis after adjusting any other factors, with an adjusted odds ratio of 10.73 and a 95% confidence interval of 3.98 to 28.87 (p<0.001). Conclusion: The patients with plaque psoriasis were 10.73 times significantly greater to predict CAVI greater than 8.0 or AS than non-psoriatic group. To prevent cardiovascular events and further long-term complications, early cardiovascular screening with CAVI in psoriasis patients is an optional evaluation tool.

To describe the efficacy of steps I-II-III of periodontal therapy performed in a specialist university setting following EFP S3 treatment guideline and to assess factors associated with the achievement of endpoints of therapy (EoT). Records of 131 stage III-IV periodontitis patients were collected retrospectively. Residual pockets (probing pocket depth [PPD] 5 mm with bleeding on probing [BoP] or PPD ≥ 6 mm) after steps I-II (T1) received repeated subgingival instrumentation (RSI) or surgery and were re-evaluated after 1 year (T2). EoT (no PPD ≥ 5 mm BoP+ and no PPD ≥ 6 mm) rate at T1 and T2 was computed, and predictors explored through multilevel analyses. At T1, EoT was 67.8%, with step III yielding an additional 90.0% of EoT in PPD = 5 mm BoP+ and 85.3% in PPD ≥ 6 mm. Factors negatively associated with EoT were: posterior teeth, furcation involvement (degree II-III), initial PPD, interproximal location and plaque. When considering only pockets ≥ 6 mm, factors were PPD at T1, type of intervention (resective surgery over RSI) and plaque at T2. Overall, 55.7% of patients reached EoT, 16.1% achieved 'stable periodontitis' (PPD ≤ 4 mm, no PPD = 4 mm BoP+, BoP < 10%). Guideline-based periodontal therapy achieved EoT targets in 93.3% of sites and 50% of patients with Stage III-IV periodontitis.

Accurately identifying coronary vulnerable plaque that would cause major adverse clinical events based on morphological characteristics remains a major clinical challenge. Plaque biomechanics are closely associated with plaque rupture and could assist in rupture risk stratification to identify high-risk coronary plaques for potential intervention. In vivo optical coherence tomography images of 40 coronary plaques from 40 patients with coronary artery disease were acquired and categorized into three groups according to their morphological characteristics: stable, vulnerable, and ruptured plaques. Finite element analysis was performed to obtain the peak stress value over the fibrous cap and shoulder region denoted as critical plaque wall stress (CPWS). A rupture risk stratification scheme was proposed based on the CPWS value to classify three plaque groups from biomechanical perspective, and its agreement rate with morphological classification was calculated. Ruptured and vulnerable plaques exhibited significant higher CPWS values than stable ones while no significant difference was found between ruptured and vulnerable plaques. The biomechanical risk stratification scheme was formed using 150kPa and 230kPa as threshold values for CPWS to classify three types of plaques, and its agreement rates with morphological classification were 17/20, 5/10, and 7/10 for stable, vulnerable, and ruptured plaques, respectively. This biomechanical scheme holds the potential to accurately stratify the rupture risk of coronary plaques as demonstrated by reasonable concordance with morphological classification. Discrepancy between two classifications highlights the unique value of biomechanical scheme, when integrated with morphological classification, in preventing unnecessary interventions and detecting rupture-prone plaques.

ObjectiveThis study aimed to investigate the relationship between carotid atherosclerotic plaque characteristics, as assessed by computed tomography angiography (CTA), and white matter hyperintensity (WMH) in patients with carotid atherosclerosis.MethodsA total of 180 patients with carotid atherosclerosis who underwent both carotid CTA and brain MRI were retrospectively enrolled. WMH severity on T2-weighted fluid-attenuated inversion recovery (T2-FLAIR) images was graded using the Fazekas scale, with patients categorized into the none/mild (n = 77) and severe (n = 103) WMH groups. Plaque thickness, length, and stenosis were measured on CTA multiplanar reconstruction (MPR) and curved planar reformation (CPR) images. Plaque calcification types were classified according to Saba’s criteria. Quantitative WMH volumes were automatically segmented into four subregions using an artificial intelligence-assisted platform. Logistic regression and Spearman correlation analyses were performed to evaluate associations between plaque characteristics and WMH burden.ResultsPatients with severe WMH exhibited greater plaque thickness (4.20 vs. 2.80 mm, p < 0.001) and higher stenosis (52.0% vs. 28.0%, p < 0.001). After multivariate adjustment using a fully adjusted model including demographic variables, vascular risk factors, and lipid profile parameters, maximal plaque thickness (OR = 1.669) and stenosis degree (OR = 1.044) remained independent predictors of severe WMH (p < 0.001). Plaque thickness showed the strongest correlations with WMH volumes in the periventricular (r = 0.429) and juxtaventricular (r = 0.383) regions (p < 0.001), whereas plaque length showed no significant associations. Rim sign-positive calcified plaques (type 6) were significantly correlated with total WMH volume (β = 0.359, p = 0.045).ConclusionCarotid plaque thickness and stenosis are independently associated with WMH severity, particularly affecting periventricular regions. These findings suggest that carotid atherosclerosis may contribute to cerebral small vessel disease (CSVD) progression through hemodynamic or embolic mechanisms.