Dai An, Yao Weinan, Lei Jing, Yan Limin, Dang Lei, Zhao Haijun, Gu Jingshun, Li Jun, Nie Ying, Zheng Mengru, Wang Dongchun, Wang Qingwen
Department of Ultrasound, Tangshan Gongren Hospital, Tangshan.
Department of Radiotherapy, North China University of Science and Technology Affiliated Hospital Tangshan.
J Craniofac Surg. 2024 May 17. doi: 10.1097/SCS.0000000000010276.
In this study, the authors aimed to evaluate the relationship between pericarotid fat density (PFD) and pathologic carotid plaque risk characteristics.
The authors retrospectively evaluated 58 patients (mean age: 66.66 ± 7.26 y, 44 males) who were subjected to both carotid endarterectomy and carotid artery computed tomography angiography (CTA) at the authors' institution. The computed tomography values of the adipose tissue around the most severe stenosis carotid artery were measured, and the removed plaques were sent to the Department of Pathology for American Heart Association (AHA) classification. The Wilcoxon signed-rank test was used to detect the difference in PFD values between the operative and nonoperative sides. According to carotid plaque risk characteristics, the associations between PFD and 4 different risk characteristic subgroups were analyzed. The Student t test and χ2 test were used to compare differences between different risk subgroups. Receiver operating characteristic curve analysis was used to evaluate the predictive efficacy of PFD for carotid plaque risk characteristics.
The operative side had higher mean Hounsfield units (HU) values compared with the nonoperative side (P < 0.001). The AHA VI and the intraplaque hemorrhage (IPH) subgroups had higher mean HU values compared with the non-AHA VI and the non-IPH subgroups (P < 0.05). Male patients presented with IPH more than female patients (P = 0.047). The results of receiver operating characteristic curve analysis showed that the mean HU value (operative side; area under the curve: 0.729, Sensitivity (SE): 59.26%, Specificity (SP): 80.65%, P = 0.003) had a certain predictive value for diagnosing high-risk VI plaques. Pericarotid fat density ≥ -68.167 HU is expected to serve as a potential cutoff value to identify AHA VI and non-AHA VI subgroups.
PFD was significantly associated with vulnerable plaques, high-risk AHA VI plaques, and IPH, which could be an indirect clinical marker for vulnerable plaques.
在本研究中，作者旨在评估颈动脉周围脂肪密度（PFD）与病理性颈动脉斑块风险特征之间的关系。
作者回顾性评估了58例患者（平均年龄：66.66±7.26岁，44例男性），这些患者在作者所在机构接受了颈动脉内膜切除术和颈动脉计算机断层扫描血管造影（CTA）。测量最严重狭窄颈动脉周围脂肪组织的计算机断层扫描值，并将切除的斑块送至病理科进行美国心脏协会（AHA）分类。采用Wilcoxon符号秩检验检测手术侧和非手术侧PFD值的差异。根据颈动脉斑块风险特征，分析PFD与4个不同风险特征亚组之间的关联。采用Student t检验和χ2检验比较不同风险亚组之间的差异。采用受试者操作特征曲线分析评估PFD对颈动脉斑块风险特征的预测效能。
手术侧的平均亨氏单位（HU）值高于非手术侧（P<0.001）。与非AHA VI和非斑块内出血（IPH）亚组相比，AHA VI和IPH亚组的平均HU值更高（P<0.05）。男性患者出现IPH的情况多于女性患者（P=0.047）。受试者操作特征曲线分析结果显示，平均HU值（手术侧；曲线下面积：0.729，灵敏度（SE）：59.26%，特异度（SP）：80.65%，P=0.003）对诊断高危VI型斑块具有一定的预测价值。颈动脉周围脂肪密度≥-68.167 HU有望作为识别AHA VI和非AHA VI亚组的潜在临界值。
PFD与易损斑块、高危AHA VI型斑块和IPH显著相关，可能是易损斑块的间接临床标志物。
