School of Medicine, Shandong First Medical University, Jinan, Shandong 271099,China.
Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China.
Eur J Radiol. 2022 May;150:110269. doi: 10.1016/j.ejrad.2022.110269. Epub 2022 Mar 18.
Perivascular fat attenuation index is considered a sensitive biomarker of vulnerable coronary plaques. However, its application in studying the carotid artery are unknown.
This study aimed to explore the association between cerebrovascular symptoms and carotid attenuation density of perivascular adipose tissue (PVAT) on computed tomography angiography (CTA).
A total of 206 participants (mean age, 63.9 ± 7.9 years, 145 men) who underwent CTA were retrospectively analyzed. Perivascular fat density (PFD) was evaluated via CTA. The association between PFD and the occurrence of cerebrovascular symptoms was examined via generalized estimating equations and receiver operating characteristic analysis.
Among the 206 subjects, 49.5% (plaques were observed in 102 patients) presented cerebrovascular symptoms. Plaques with symptoms (-55.0 ± 10.0 Hounsfield units [HU]) had a higher PFD than those without symptoms (-68.0 ± 10.3 HU) (p < 0.001). After adjusting for hyperlipidemia, statin use, antiplatelet use, calcification, degree of luminal stenosis, maximum plaque thickness, and ulceration, PFD was found to be strongly associated with cerebrovascular symptoms (OR, 1.13; 95% CI, 1.07-1.19; p < 0.001). Receiver operating characteristic analysis revealed an area under the curve of 0.81 by using PFD measurements to discriminate between symptomatic and asymptomatic plaques with a sensitivity of 87.3% and a specificity of 60.6%.
An increase in attenuation density of PVAT on CTA was found to be related to an increase in the risks of cerebrovascular symptoms. PFD might serve as an imaging marker of symptomatic carotid plaques.
血管周围脂肪衰减指数被认为是易损性冠状动脉斑块的敏感生物标志物。然而，其在研究颈动脉中的应用尚不清楚。
本研究旨在探讨颈动脉血管周围脂肪组织（PVAT）衰减密度与脑血管症状之间的关系。
回顾性分析了 206 名接受 CT 血管造影（CTA）的患者（平均年龄 63.9±7.9 岁，145 名男性）。通过 CTA 评估血管周围脂肪密度（PFD）。采用广义估计方程和受试者工作特征曲线分析 PFD 与脑血管症状发生之间的关系。
在 206 名受试者中，49.5%（102 名患者）有脑血管症状。有症状的斑块（-55.0±10.0 Hounsfield 单位[HU]）的 PFD 高于无症状斑块（-68.0±10.3 HU）（p<0.001）。在校正高血脂、他汀类药物使用、抗血小板药物使用、钙化、管腔狭窄程度、最大斑块厚度和溃疡后，PFD 与脑血管症状密切相关（OR，1.13；95%CI，1.07-1.19；p<0.001）。使用 PFD 测量值区分有症状和无症状斑块的受试者工作特征曲线分析显示，曲线下面积为 0.81，敏感性为 87.3%，特异性为 60.6%。
CTA 上 PVAT 衰减密度的增加与脑血管症状风险的增加有关。PFD 可能是颈动脉有症状斑块的影像学标志物。
