Construction of a risk prediction model for concomitant AIS in elderly patients with cervical artery dissection based on VW-MRI findings
10.3969/j.issn.1009-0126.2025.03.021
- VernacularTitle:基于血管壁磁共振成像构建老年颈部动脉夹层并发急性缺血性脑卒中风险预测模型
- Author:
Bo LI
1
;
Guannan LIU
1
;
Hailei FAN
1
Author Information
1. 473000 南阳市第一人民医院磁共振诊断室
- Publication Type:Journal Article
- Keywords:
magnetic resonance imaging;
carotid artery,internal,dissection;
ischemic stroke;
risk factors;
nomograms;
ROC curve;
forecasting;
proportional hazards models
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2025;27(3):354-358
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors for concomitant acute ischemic stroke(AIS)in elderly patients with cervical artery dissection(CAD)based on high-resolution vessel wall mag-netic resonance imaging(VW-MRI)features,and to construct a nomogram prediction model.Methods A retrospective analysis was performed on 125 CAD patients admitted to our hospital from April 2021 to April 2024.According to complication of AIS or not,they were divided into a concomitant group(52 cases)and a non-concomitant group(73 cases).The general data and VW-MRI features were collected and analyzed in the two groups.Multivariate logistic regression analy-sis was used to identify the risk factors for AIS in CAD patients.Then a nomogram prediction model was constructed,and ROC curve was plotted to analyze its predictive efficacy.Results Sig-nificantly larger proportions of smoking history,hypertension and hyperlipidemia,and higher LDL-C level were observed in the concomitant group than the non-concomitant group(50.00％vs 30.14％,P=0.024;42.31％vs 12.33％,P=0.000;36.54％vs 10.96％,P=0.001;1.15±0.36 mmol/L vs 1.03±0.31 mmol/L,P=0.048).The incidences of multiple lesions,double lumen sign,high signal intensity of intramural hematoma,intralumenal thrombus,and severe vascular stenosis/occlusion were obviously higher(38.46％vs 16.44％,P=0.005;44.23％vs 13.70％,P=0.000;48.08％vs 16.44％,P=0.000;50.00％vs 12.33％,P=0.000;28.85％vs 5.48％,P=0.000),while that of moderate vascular stenosis was notably lower in the concomitant group than the non-concomitant group(44.23％vs 63.01％,P=0.037).Smoking history,hypertension,hy-perlipidemia,number of lesions,double lumen sign,signal intensity of intermural hematoma,in-traluminal thrombus,and severity of stenosis were risk factors for AIS occurrence in CAD pa-tients(P＜0.05,P＜0.01).For our risk prediction model based on the above risk factors,calibra-tion curve analysis showed a consistency index(C-index)of 0.856,Hosmer-Lemeshow goodness-of-fit test indicated X2=5.947,P=0.625,and an AUC value was 0.924(95％CI:0.833-0.961,P＜0.05),with a sensitivity and a specificity of 88.86％and 75.36％,respectively.Conclusion Smoking history,hypertension,hyperlipidemia,number of lesions,double lumen sign,signal in-tensity of intermural hematoma,intraluminal thrombus,and severity of stenosis are risk factors for AIS occurrence in CAD patients.Our nomogram model based on these factors has a good pre-dictive performance for the complication of AIS in these patients.
