基于CTA图像的可解释多模态深度学习用于预测颈动脉支架置入术引起的颈动脉窦反应

注册号:

Registration number:

ChiCTR2600121058 

最近更新日期:

Date of Last Refreshed on:

2026-03-25 08:39:58 

注册时间:

Date of Registration:

2026-03-25 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

基于CTA图像的可解释多模态深度学习用于预测颈动脉支架置入术引起的颈动脉窦反应

Public title:

Interpretable Multimodal Deep Learning Based on Computed Tomography Angiography for Predicting Carotid Sinus Reaction Induced by Carotid Artery Stenting

注册题目简写:

English Acronym:

研究课题的正式科学名称:

基于CTA图像的可解释多模态深度学习用于预测颈动脉支架置入术引起的颈动脉窦反应

Scientific title:

Interpretable Multimodal Deep Learning Based on Computed Tomography Angiography for Predicting Carotid Sinus Reaction Induced by Carotid Artery Stenting

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

马杨平 

研究负责人:

姚一龙 

Applicant:

Ma Yangping 

Study leader:

Yao Yilong 

申请注册联系人电话:

Applicant telephone:

+86 176 9322 3223

研究负责人电话:

Study leader's
telephone:

+86 189 4025 2644

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

mayangping@cmu.edu.cn

研究负责人电子邮件:

Study leader's E-mail:

yaoyilong_322@163.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

中国辽宁省沈阳市和平区三好街36号

研究负责人通讯地址:

中国辽宁省沈阳市和平区三好街36号

Applicant address:

36 Sanhao Street, Heping District, Shenyang, Liaoning, China

Study leader's address:

36 Sanhao Street, Heping District, Shenyang, Liaoning, China

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

中国医科大学附属盛京医院

Applicant's institution:

Shengjing Hospital of China Medical University

研究负责人所在单位:

中国医科大学附属盛京医院

Affiliation of the Leader:

Shengjing Hospital of China Medical University

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

2026PS509K

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

中国医科大学附属盛京医院医学伦理委员会

Name of the ethic committee:

Medical Ethics Committee of Shengjing Hospital Affiliated to China Medical University

伦理委员会批准日期:

Date of approved by ethic committee:

2026-03-05 00:00:00

伦理委员会联系人:

金晶

Contact Name of the ethic committee:

Jin Jing

伦理委员会联系地址:

中国辽宁省沈阳市和平区三好街36号

Contact Address of the ethic committee:

36 Sanhao Street, Heping District, Shenyang, Liaoning, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 24 966 151 0027

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

中国医科大学附属盛京医院

Primary sponsor:

Shengjing Hospital of China Medical University

研究实施负责(组长)单位地址:

中国辽宁省沈阳市和平区三好街36号

Primary sponsor's address:

36 Sanhao Street, Heping District, Shenyang, Liaoning, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

辽宁

市(区县):

沈阳

Country:

China

Province:

Liaoning

City:

Shenyang

单位(医院):

中国医科大学附属盛京医院

具体地址:

中国辽宁省沈阳市和平区三好街36号

Institution
hospital:

Shengjing Hospital of China Medical University

Address:

36 Sanhao Street, Heping District, Shenyang, Liaoning, China

经费或物资来源:

本研究得到国家自然科学基金(82002652)资助。

Source(s) of funding:

This work was funded by the National Natural Science Foundation of China (82002652 to YY).

研究疾病:

颈动脉窦反应  

Target disease:

Carotid Sinus Reaction

研究疾病代码:

Target disease code:

研究类型:

观察性研究

Study type:

Observational study

研究所处阶段:

回顾性研究 

Study phase:

Retrospective study

研究设计:

连续入组 

Study design:

Sequential 

研究目的:

本研究是通过基于术前CTA图像的可解释多模态深度学习模型来预测颈动脉支架置入术引起的颈动脉窦反应,为临床提供了可靠的手术相关并发症发生风险的预警工具。模型可在实施颈动脉支架置入术术前根据患者的颈动脉CTA影像和相关临床数据识别发生颈动脉窦反应的高风险个体,辅助医生制定个体化的围术期管理策略,降低手术并发症的发生风险,提升手术安全性与成功率。同时,该方法的研究成果可进一步推广至其他介入操作过程中的生理事件预测,为智能围术期风险管理提供通用的技术框架。  

Objectives of Study:

To develop an interpretable multimodal deep learning model integrating preoperative computed tomography angiography (CTA) and clinical data to predict carotid artery stenting (CAS)-induced carotid sinus reaction (CSR). This study aims to identify high-risk patients preoperatively, thereby facilitating personalized perioperative management and establishing a generalizable framework for intelligent risk prediction in interventional procedures.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1. 已知的颈动脉窦综合征或体位性晕厥病史; 2. 术前3个月内规律使用显著影响自主神经功能的药物(如β受体阻滞剂、非二氢吡啶类钙拮抗剂、洋地黄类等),且术前未停药 >= 5个半衰期; 3. 术前心电图提示窦性心动过缓(静息心率持续 <= 50次/分)或诊断为病态窦房结综合征; 4. 严重心脏传导阻滞(二度II型及以上房室传导阻滞、三度房室传导阻滞)或依赖性心脏起搏器; 5. 颈部放疗史; 6. 本次手术侧颈部有严重外伤史或外科手术史; 7. 颈动脉支架内再狭窄,即本次处理颈动脉狭窄处既往接受过颈动脉支架置入术; 8. 颈动脉内膜剥脱术后再狭窄,即本次处理颈动脉狭窄处既往接受过颈动脉内膜剥脱术; 9. 术中未成功放置支架; 10. 围手术期发生急性心肌梗死、严重心律失常(如室速、室颤)或其他重大心血管事件; 11. 围术期发生颅内出血、大面积脑梗死(梗死体积 > 80ml)等严重的神经系统疾病; 12. 围术期发生碘造影剂严重过敏事件; 13. 严重慢性呼吸系统疾病,如慢性阻塞性肺疾病(GOLD 3–4级)或长期家庭氧疗依赖者; 14. 存在活动性恶性肿瘤(非皮肤基底细胞癌或原位癌)且伴6个月内非自愿体重减轻 >= 10%,或体质指数(BMI)<18.5 kg/m²(排除水肿或腹水干扰),或临床明确诊断为恶病质或重度营养不良; 15. CTA图像质量不合格,存在明显伪影、钙化干扰严重、扫描范围不全或分辨率不足等,影响图像后处理与特征提取(由至少两位经验丰富的神经外科医生独立评估)。

Exclusion criteria:

1. Known history of carotid sinus syndrome or orthostatic syncope; 2. Regular use of medications significantly affecting autonomic nervous function (e.g., beta-blockers, non-dihydropyridine calcium channel blockers, or digitalis) within 3 months prior to surgery, without a washout period of ≥ 5 half-lives before the procedure; 3. Preoperative electrocardiogram (ECG) indicating sinus bradycardia (sustained resting heart rate ≤ 50 beats/min) or a diagnosis of sick sinus syndrome; 4. Severe heart block (second-degree type II or higher atrioventricular block, third-degree atrioventricular block) or pacemaker dependency; 5. History of neck radiotherapy; 6. History of severe trauma or surgical procedures on the ipsilateral neck; 7. Carotid in-stent restenosis (i.e., previous carotid artery stenting at the target lesion); 8. Restenosis following carotid endarterectomy (CEA) (i.e., previous CEA at the target lesion); 9. Unsuccessful stent deployment during the procedure; 10. Perioperative occurrence of acute myocardial infarction, severe arrhythmias (e.g., ventricular tachycardia, ventricular fibrillation), or other major cardiovascular events; 11. Perioperative severe neurological complications, such as intracranial hemorrhage or massive cerebral infarction (infarct volume > 80 mL); 12. Severe allergic reactions to iodine contrast agents during the perioperative period; 13. Severe chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD, GOLD stage 3–4) or dependence on long-term home oxygen therapy; 14. Presence of active malignancies (excluding basal cell carcinoma of the skin or carcinoma in situ) accompanied by involuntary weight loss of ≥ 10% within 6 months, a body mass index (BMI) < 18.5 kg/m² (excluding confounding by edema or ascites), or a confirmed clinical diagnosis of cachexia or severe malnutrition; 15. Substandard CTA image quality due to significant artifacts, severe calcification interference, incomplete scanning coverage, or insufficient resolution that impairs image post-processing and feature extraction (independently assessed by at least two experienced neurosurgeons).

研究实施时间:

Study execute time:

From 2026-03-27 00:00:00 To 2026-09-30 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-03-27 00:00:00 To 2026-06-30 00:00:00

干预措施:

Interventions:

组别:

颈动脉支架置入术术中或术后24小时内发生颈动脉窦反应

样本量:

400

Group:

CSR Group: Patients who developed carotid sinus reaction (CSR) intraoperatively or within 24 hours following carotid artery stenting (CAS).

Sample size:

干预措施:

干预措施代码:

Intervention:

None

Intervention code:

组别:

颈动脉支架置入术术中或术后24小时内未发生颈动脉窦反应

样本量:

600

Group:

Non-CSR Group: Patients who did not develop carotid sinus reaction (CSR) intraoperatively or within 24 hours following carotid artery stenting (CAS).

Sample size:

干预措施:

干预措施代码:

Intervention:

None

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

辽宁 

市(区县):

沈阳 

Country:

China

Province:

Liaoning

City:

Shenyang

单位(医院):

中国医科大学附属盛京医院 

单位级别:

三甲 

Institution
hospital:

Shengjing Hospital of China Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

辽宁 

市(区县):

沈阳 

Country:

China

Province:

Liaoning

City:

Shenyang

单位(医院):

辽宁省人民医院 

单位级别:

三甲 

Institution
hospital:

People's Hospital of Liaoning Province

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

辽宁 

市(区县):

沈阳 

Country:

China

Province:

Liaoning

City:

Shenyang

单位(医院):

中国医科大学附属第一医院 

单位级别:

三甲 

Institution
hospital:

First Hospital of China Medical University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

精确率

指标类型:

主要指标

Outcome:

Precision

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

召回率

指标类型:

主要指标

Outcome:

Recall

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

F1值

指标类型:

主要指标

Outcome:

F1-score

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

ROC曲线下面积

指标类型:

主要指标

Outcome:

AUC (area under the receiver operating characteristic curve)

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

微平均准确率

指标类型:

主要指标

Outcome:

Micro-ACC (micro-averaged accuracy)

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

None

Tissue:

人体标本去向

其它  

说明

Fate of sample:

0thers  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 80 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

Randomization Procedure (please state who generates the random number sequence and by what method):

None

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

Blinding:

None

是否共享原始数据:

IPD sharing

否No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

None

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

电子采集和管理

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Electronic Data Capture

数据与安全监察委员会:

Data and Safety Monitoring Committee:

无/No

注册人:

Name of Registration:

 2026-03-25 08:39:41