ArticleEuropean radiology2024
Increased incidence of napkin-ring sign plaques on cervicocerebral computed tomography angiography associated with the risk of acute ischemic stroke occurrence.
Article in European radiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 10 citations in OpenAlex.
- Carotid napkin-ring sign plaques are associated with early neurological deterioration in lenticulostriate artery branch atheromatous disease.Frontiers in neurology · 2026Article
- Napkin-ring sign plaques are associated with cerebral small vessel disease.European journal of medical research · 2025Article
- Comparison of "one-stop" coronary and head-and-neck computed tomography angiography with different scan sequences using a wide-detector system: heart-to-cranialQuantitative imaging in medicine and surgery · 2025Article
- A Study of Knowledge and Attitude of Medical Staff Towards 3D Black Blood MR Angio Methods in High-Resolution Magnetic Resonance Vessel Wall Imaging of Intracranial Arteries.Journal of multidisciplinary healthcare · 2025Article
- Detectability of intracranial vessel wall atherosclerosis using black-blood spectral CT: a phantom and clinical study.European radiology experimental · 2024Article
- Association between atherosclerosis and the development of multi-organ pathologies.SAGE open medicine · 2024Review
- Napkin-ring sign plaques are associated with clinical outcome in patients with acute ischemic stroke after endovascular therapy.Frontiers in neurologyArticle
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Authors and funding
9 authors at 5 institutions in 3 countries.
Funding
Abstract
objectivesCarotid atherosclerosis plays an essential role in the occurrence of ischemic stroke. This study aimed to investigate whether a larger burden of napkin-ring sign (NRS) plaques on cervicocerebral computed tomography angiography (CTA) increased the risk of acute ischemic stroke (AIS).
methodsThis retrospective, single-center, cross-sectional study enrolled patients with NRS plaques identified in the subclavian arteries, brachiocephalic trunk, carotid arterial system, and vertebrobasilar circulation on contrast-enhanced cervicocerebral CTA. Patients were divided into AIS and non-AIS groups based on imaging within 12 h of symptom onset. Univariate and multivariate logistic regression analyses were performed to determine the risk factor of AIS occurrence.
resultsA total of 202 patients (66.72 years ± 8.97, 157 men) were evaluated. Plaques with NRS in each subject of the AIS group (N = 98) were significantly more prevalent than that in the control group (N = 104) (1.96 ± 1.17 vs 1.41 ± 0.62). In the AIS group, there were substantially more NRS plaques on the ipsilateral side than contralateral side (1.55 ± 0.90 vs. 0.41 ± 0.66). NRS located on the ipsilateral side of the AIS showed an area under the receiver curve (AUC) of 0.86 to identify ischemic stroke. NRS plaque amounts were an independent risk factor for AIS occurrence (odds ratio, 1.86) after adjusting for other factors.
conclusionsIncreased incidence of napkin-ring sign plaques on cervicocerebral CTA was positively associated with AIS occurrence, which could aid in detecting asymptomatic atherosclerotic patients at high risk of AIS in routine screening or emergency settings. CLINICAL RELEVANCE STATEMENT: Napkin-ring sign plaque provides an important imaging target for estimating acute ischemic stroke risk and identifying high-risk patients in routine screening or emergency settings, so that timely anti-atherosclerotic therapy can be used for prevention. KEY POINTS: • This cross-sectional study investigated the association between high-risk carotid artery plaques and acute ischemic stroke. • Increased incidence of napkin-ring sign plaques on cervicocerebral computed tomography angiography is positively associated with acute ischemic stroke occurrence. • Napkin-ring signs help identify risky patients prone to acute ischemic stroke to facilitate prevention.
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