基于计算机辅助的非对比 CT 对心包和胸腔脂肪的定量分析及其与冠状动脉钙和代谢综合征的相关性研究。
Computer-aided non-contrast CT-based quantification of pericardial and thoracic fat and their associations with coronary calcium and Metabolic Syndrome.
机构信息
Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
出版信息
Atherosclerosis. 2010 Mar;209(1):136-41. doi: 10.1016/j.atherosclerosis.2009.08.032. Epub 2009 Aug 21.
INTRODUCTION
Pericardial fat is emerging as an important parameter for cardiovascular risk stratification. We extended previously developed quantitation of thoracic fat volume (TFV) from non-contrast coronary calcium (CC) CT scans to also quantify pericardial fat volume (PFV) and investigated the associations of PFV and TFV with CC and the Metabolic Syndrome (METS).
METHODS
TFV is quantified automatically from user-defined range of CT slices covering the heart. Pericardial fat contours are generated by spline interpolation between 5-7 control points, placed manually on the pericardium within this cardiac range. Contiguous fat voxels within the pericardium are identified as pericardial fat. PFV and TFV were measured from non-contrast CT for 201 patients. In 105 patients, abdominal visceral fat area (VFA) was measured from an additional single-slice CT. In 26 patients, images were quantified by two readers to establish inter-observer variability. TFV and PFV were examined in relation to Body Mass Index (BMI), waist circumference and VFA, standard coronary risk factors (RF), CC (Agatston score >0) and METS.
RESULTS
PFV and TFV showed excellent correlation with VFA (R=0.79, R=0.89, p<0.0001), and moderate correlation with BMI (R=0.49, R=0.48, p<0.0001). In 26 scans, the inter-observer variability was greater for PFV (8.0+/-5.3%) than for TFV (4.4+/-3.9%, p=0.001). PFV and TFV, but not RF, were associated with CC [PFV: p=0.04, Odds Ratio 3.1; TFV: p<0.001, OR 7.9]. PFV and TFV were also associated with METS [PFV: p<0.001, OR 6.1; TFV p<0.001, OR 5.7], unlike CC [OR=1.0 p=NS] or RF. PFV correlated with low-HDL and high-glucose; TFV correlated with low-HDL, low-adiponectin, and high glucose and triglyceride levels.
CONCLUSIONS
PFV and TFV can be obtained easily and reproducibly from routine CC scoring scans, and may be important for risk stratification and monitoring.
简介
心包脂肪正逐渐成为心血管风险分层的一个重要参数。我们将之前开发的用于定量非对比性冠状动脉钙（CC）CT 扫描的胸腔脂肪量（TFV）扩展到心包脂肪量（PFV）的定量，并研究了 PFV 和 TFV 与 CC 和代谢综合征（METS）的相关性。
方法
TFV 是从涵盖心脏的用户定义 CT 切片范围内自动定量的。在心包内的 5-7 个控制点之间用样条插值生成心包脂肪轮廓，在此心脏范围内手动放置。心包内的连续脂肪体素被识别为心包脂肪。从 201 名患者的非对比 CT 中测量 PFV 和 TFV。在 105 名患者中，从额外的单切片 CT 中测量腹部内脏脂肪面积（VFA）。在 26 名患者中，由两名读者对图像进行量化，以确定观察者间的变异性。在 26 名患者中，由两名读者对图像进行量化，以确定观察者间的变异性。PFV 和 TFV 与体重指数（BMI）、腰围和 VFA、标准冠状动脉危险因素（RF）、CC（Agatston 评分>0）和 METS 进行了检查。
结果
PFV 和 TFV 与 VFA 有很好的相关性（R=0.79，R=0.89，p<0.0001），与 BMI 有中度相关性（R=0.49，R=0.48，p<0.0001）。在 26 次扫描中，PFV 的观察者间变异性大于 TFV（8.0+/-5.3%比 4.4+/-3.9%，p=0.001）。PFV 和 TFV 与 CC 相关[PFV：p=0.04，比值比 3.1；TFV：p<0.001，OR 7.9]，而不是 RF。PFV 和 TFV 与 METS 也相关[PFV：p<0.001，OR 6.1；TFV：p<0.001，OR 5.7]，与 CC 不同[OR=1.0 p=NS]或 RF。PFV 与低 HDL 和高血糖相关；TFV 与低 HDL、低脂联素和高血糖及甘油三酯水平相关。
结论
PFV 和 TFV 可从常规 CC 评分扫描中轻松且可重复地获得，可能对风险分层和监测具有重要意义。
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