Liu Ying, Huo Ran, Xu Huimin, Zhou Guangjin, Wang Tao, Yuan Huishu, Zhao Xihai
Department of Radiology, Peking University Third Hospital, Beijing, China.
Department of Neurosurgery, Peking University Third Hospital, Beijing, China.
Front Neurol. 2022 Jul 5;13:899957. doi: 10.3389/fneur.2022.899957. eCollection 2022.
To examine the associations between carotid plaque characteristics and perioperative cerebral blood flow (CBF) by arterial spin labeling (ASL) imaging.
Patients with unilateral moderate-to-severe carotid stenosis referred for carotid endarterectomy (CEA) were recruited and underwent carotid vessel wall and brain ASL magnetic resonance imaging. The following imaging features were measured: relative CBF (rCBF = CBF /CBF ) in the middle cerebral artery territory; plaque burden and the presence of lipid-rich necrotic core; intraplaque hemorrhage (IPH); calcification; ulcer and fibrous-cap rupture; and the volume and maximum plaque components' area percentages. The associations between plaque characteristics and perioperative CBF were analyzed.
Sixty-one patients (mean age, 66.6 ± 7.8 years; 55 males) were included. Univariate linear regression showed that rCBF was associated with stenosis [β, -0.462; 95% confidence interval (CI), from -0.797 to -0.126; = 0.008], calcification (β, 0.103; 95% CI, 0.005-0.201; = 0.040), maximum IPH area percentage (β, -0.127; 95% CI, from -0.223 to -0.030; = 0.012), and ulcer (β, 0.069; 95% CI, 0.025-0.113; = 0.005); rCBF was associated with the IPH volume (β, -0.060; 95% CI, from -0.107 to -0.014; = 0.013). After adjusting for the confounding factors, the associations of calcification with rCBF (β, 0.099; 95% CI, from 0.004 to -0.194; = 0.042) and IPH volume with rCBF (β, -0.060; 95% CI, from -0.109 to -0.011; = 0.020) remained statistically significant, while those of rCBF with maximum IPH area percentage (β, -0.089; 95% CI, from -0.188 to 0.011; = 0.080) and ulcer (β, 0.050; 95% CI, from -0.012 to 0.112; = 0.100) did not remain statistically significant.
The compositional characteristics of carotid atherosclerotic plaques, particularly IPH, were associated with perioperative CBF in patients with unilateral moderate-to-severe carotid stenosis undergoing CEA. Our findings indicated that the patients with larger carotid IPH could expect smaller improvement in CBF following CEA.
通过动脉自旋标记（ASL）成像检查颈动脉斑块特征与围手术期脑血流量（CBF）之间的关联。
招募因颈动脉内膜切除术（CEA）而转诊的单侧中度至重度颈动脉狭窄患者，并对其进行颈动脉血管壁和脑部ASL磁共振成像检查。测量以下成像特征：大脑中动脉区域的相对脑血流量（rCBF = CBF /CBF ）；斑块负荷以及富含脂质的坏死核心的存在情况；斑块内出血（IPH）；钙化；溃疡和纤维帽破裂；以及斑块体积和最大斑块成分的面积百分比。分析斑块特征与围手术期CBF之间的关联。
纳入61例患者（平均年龄66.6±7.8岁；55例男性）。单因素线性回归显示，rCBF与狭窄程度[β，-0.462；95%置信区间（CI），-0.797至-0.126；P = 0.008]、钙化（β，0.103；95%CI，0.005 - 0.201；P = 0.040）、最大IPH面积百分比（β，-0.127；95%CI，-0.223至-0.030；P = 0.012）以及溃疡（β，0.
