<br>颈动脉斑块-RADS：一种新型中风风险分类系统,JACC: Cardiovascular Imaging

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颈动脉斑块-RADS：一种新型中风风险分类系统
JACC: Cardiovascular Imaging ( IF 12.8 ) Pub Date : 2023-10-11 , DOI: 10.1016/j.jcmg.2023.09.005
Luca Saba ₁ , Riccardo Cau ₁ , Alessandro Murgia ₁ , Andrew N Nicolaides ₂ , Max Wintermark ₃ , Mauricio Castillo ₄ , Daniel Staub ₅ , Stavros K Kakkos ₆ , Qi Yang ₇ , Kosmas I Paraskevas ₈ , Chun Yuan ₉ , Myriam Edjlali ₁₀ , Roberto Sanfilippo ₁₁ , Jeroen Hendrikse ₁₂ , Elias Johansson ₁₃ , Mahmud Mossa-Basha ₉ , Niranjan Balu ₁₄ , Martin Dichgans ₁₅ , David Saloner ₁₆ , Daniel Bos ₁₇ , H Rolf Jager ₁₈ , Ross Naylor ₁₉ , Gavino Faa ₂₀ , Jasjit S Suri ₂₁ , Justin Costello ₂₂ , Dorothee P Auer ₂₃ , J Scott Mcnally ₂₄ , Leo H Bonati ₂₅ , Valentina Nardi ₂₆ , Aad van der Lugt ₂₇ , Maura Griffin ₂₈ , Bruce A Wasserman ₂₉ , M Eline Kooi ₃₀ , Jonathan Gillard ₃₁ , Giuseppe Lanzino ₃₂ , Dimitri P Mikhailidis ₃₃ , Daniel M Mandell ₃₄ , John C Benson ₃₅ , Dianne H K van Dam-Nolen ₂₇ , Anna Kopczak ₃₆ , Jae W Song ₃₇ , Ajay Gupta ₃₈ , J Kevin DeMarco ₃₉ , Seemant Chaturvedi ₄₀ , Renu Virmani ₄₁ , Thomas S Hatsukami ₁₄ , Martin Brown ₄₂ , Alan R Moody ₄₃ , Peter Libby ₄₄ , Andreas Schindler ₄₅ , Tobias Saam ₄₆

Affiliation

Department of Radiology, University of Cagliari, Cagliari, Italy.
Vascular Screening and Diagnostic Centre, Nicosia, Cyprus; University of Nicosia Medical School, Nicosia, Cyprus; Department of Vascular Surgery, Imperial College, London, United Kingdom.
Department of Neuroradiology, The University of Texas MD Anderson Center, Houston, Texas, USA.
Department of Radiology, University of North Carolina, Chapel Hill, North Carolina, USA.
Vascular Medicine/Angiology, University Hospital Basel and University of Basel, Basel, Switzerland.
Department of Vascular Surgery, University of Patras Medical School, Patras, Greece.
Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Department of Vascular Surgery, Central Clinic of Athens, Athens, Greece.
Department of Radiology, University of Washington, Seattle, Washington, USA.
Multimodal Biomedical Imaging Laboratory (BioMaps), Paris-Saclay University, CEA, CNRS, Inserm, Frédéric Joliot Hospital Department, Orsay, France; Department of Radiology, APHP, Paris, France.
Department of Vascular Surgery, University of Cagliari, Cagliari, Italy.
University Medical Center Utrecht, Utrecht, the Netherlands.
Clinical Science, Umeå University, Neurosciences, Umeå, Sweden.
Department of Surgery, University of Washington, Seattle, WA, USA.
Institute for Stroke and Dementia Research, University Hospital, LMU Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, California, USA.
Department of Radiology and Nuclear Medicine, Erasmus MC Rotterdam, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands; Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; Department of Clinical Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.
Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, United Kingdom.
The Leicester Vascular Institute, Glenfield Hospital, Leicester, United Kingdom.
Department of Pathology, University of Cagliari, Cagliari, Italy.
Stroke Monitoring and Diagnostic Division, AtheroPoin, Roseville, California, USA.
Department of Neuroradiology, Walter Reed National Military Medical Center and Uniformed Services University of Health Sciences, Bethesda, Maryland, USA.
Radiological Sciences, Division of Clinical Neuroscience, and NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, United Kingdom.
Department of Radiology, University of Utah, Salt Lake City, Utah, USA.
Department of Neurology and Stroke Center, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.
Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
Department of Radiology and Nuclear Medicine, Erasmus MC Rotterdam, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Vascular Screening and Diagnostic Centre, Nicosia, Cyprus.
Department of Radiology, University of Maryland School of Medicine and Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Department of Radiology and Nuclear Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, the Netherlands.
Christ's College, Cambridge, United Kingdom.
Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA.
Department of Clinical Biochemistry, Royal Free Hospital Campus, University College London School, University College London, London, United Kingdom.
Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada.
Department of Radiology Mayo Clinic, Rochester, Minnesota, USA.
Institute for Stroke and Dementia Research, University Hospital, LMU Munich, Munich, Germany.
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Department of Radiology Weill Cornell Medical College, New York, New York, USA.
Walter Reed National Military Medical Center and Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
Department of Neurology, University of Maryland Medical Center, Baltimore, Maryland, USA.
Department of Cardiovascular Pathology, CVPath Institute, Gaithersburg, Maryland, USA.
Department of Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom.
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Institute of Neuroradiology, University Hospital, LMU Munich, Munich, Germany.
Department of Radiology, University Hospital, LMU Munich, Munich, Germany; Die Radiologie, Rosenheim, Germany.

背景

颈动脉粥样硬化在普通人群中非常普遍，并且是急性缺血性中风的公认危险因素。尽管易损斑块的形态特征已得到广泛认可，但在报告和解释颈动脉斑块特征方面缺乏共识。

目标

本文的目的是通过引入斑块-RADS（报告和数据系统）评分，建立一致且全面的颈动脉斑块成像和报告方法。

方法

专家小组认识到有必要开发颈动脉斑块及其定义特征的分类系统。使用多模态分析方法，根据现有已发表的报告，通过共识建立了 Plaque-RADS 类别。

结果

作者提出了一种适用于研究人员和临床医生的通用分类。除了普遍的“狭窄”定量参数之外，Plaque-RADS 评分还提供形态学评估。 Plaque-RADS 评分范围从 1 级（表示完全没有牙菌斑）到 4 级（表示复杂的牙菌斑）。附带的视觉示例有助于清楚地理解 Plaque-RADS 类别。

结论

Plaque-RADS 是一种标准化、可靠的系统，通过不同的成像方式（例如超声、计算机断层扫描和磁共振成像）报告颈动脉斑块成分和形态。该评分系统有可能帮助准确识别哪些患者可能受益于专门的医疗干预，哪些患者需要替代治疗，从而加强患者护理。标准化词典和结构化报告有望加强放射科医生、转诊临床医生和科学家之间的沟通。

"点击查看英文标题和摘要"

Carotid Plaque-RADS: A Novel Stroke Risk Classification System

Background

Carotid artery atherosclerosis is highly prevalent in the general population and is a well-established risk factor for acute ischemic stroke. Although the morphological characteristics of vulnerable plaques are well recognized, there is a lack of consensus in reporting and interpreting carotid plaque features.

Objectives

The aim of this paper is to establish a consistent and comprehensive approach for imaging and reporting carotid plaque by introducing the Plaque–RADS (Reporting and Data System) score.

Methods

A panel of experts recognized the necessity to develop a classification system for carotid plaque and its defining characteristics. Using a multimodality analysis approach, the Plaque-RADS categories were established through consensus, drawing on existing published reports.

Results

The authors present a universal classification that is applicable to both researchers and clinicians. The Plaque-RADS score offers a morphological assessment in addition to the prevailing quantitative parameter of "stenosis." The Plaque-RADS score spans from grade 1 (indicating complete absence of plaque) to grade 4 (representing complicated plaque). Accompanying visual examples are included to facilitate a clear understanding of the Plaque-RADS categories.

Conclusions

Plaque-RADS is a standardized and reliable system of reporting carotid plaque composition and morphology via different imaging modalities, such as ultrasound, computed tomography, and magnetic resonance imaging. This scoring system has the potential to help in the precise identification of patients who may benefit from exclusive medical intervention and those who require alternative treatments, thereby enhancing patient care. A standardized lexicon and structured reporting promise to enhance communication between radiologists, referring clinicians, and scientists.

更新日期：2023-10-11

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