Department of Radiology, Kahramanmaraş Necip Fazıl City Hospital, Kahramanmaraş, Türkiye.
Department of Radiology, Ankara Bilkent City Hospital, Ankara, Türkiye.
Am J Emerg Med. 2024 Oct;84:130-134. doi: 10.1016/j.ajem.2024.08.004. Epub 2024 Aug 5.
To investigate the relationship between pericarotid fat density measured in carotid CTA and vulnerable carotid plaque.
This retrospective study included 374 participants who underwent carotid CTA between June 1, 2021, and December 1, 2021 (234 males, median age 68 years [interquartile range: 61-75]). Two groups, symptomatic and asymptomatic, were defined based on either diffusion-weighted MRI or a clinical history of acute ischemia or TIA within 6 months before or after CTA. The relationship between pericarotid fat density and cerebrovascular ischemic events was assessed using receiver operating characteristic analysis and binary logistic regression analysis.
In the symptomatic group (n = 135), mean pericarotid fat density (-63.3 ± 21.7 vs. -81.7 ± 16.9 HU, respectively; p < 0.001) and median maximum plaque thickness (4 [interquartile range: 3-6] vs. 3.7 [interquartile range: 2.6-4.7] mm, respectively; p = 0.002) were higher, while plaque density (42.1 ± 19.6 vs. 50.6 ± 20.4 HU, respectively; p = 0.001) was lower compared to the asymptomatic group. Pericarotid fat density (OR: 1.038, 95% CI: 1.023-1.053, p < 0.001) was identified as an independent predictor for symptomatic patients. The optimal cut-off value for pericarotid fat density predicting symptomatic patients was estimated as -74 HU (area under the curve: 0.753, 95% CI:0.699-0.808, p < 0.001). Inter-reader agreement for pericarotid fat density was found to be almost perfect (intraclass correlation coefficient: 0.818, 95% CI: 0.770-0.856, p < 0.001).
Pericarotid fat density may serve as an imaging biomarker in predicting acute cerebrovascular ischemic events.
本研究旨在探讨颈动脉 CT 血管造影（CTA）中测量的颈动脉周围脂肪密度与易损颈动脉斑块之间的关系。
本回顾性研究纳入了 2021 年 6 月 1 日至 12 月 1 日期间接受颈动脉 CTA 的 374 名参与者（234 名男性，中位年龄 68 岁[四分位距：61-75]）。根据弥散加权 MRI 或 CTA 前或后 6 个月内急性缺血或短暂性脑缺血发作的临床病史，将患者分为有症状组和无症状组。使用受试者工作特征分析和二元逻辑回归分析评估颈动脉周围脂肪密度与脑血管缺血事件之间的关系。
在有症状组（n=135）中，颈动脉周围脂肪密度（-63.3±21.7 比-81.7±16.9 HU；p<0.001）和最大斑块厚度中位数（4 [四分位距：3-6] 比 3.7 [四分位距：2.6-4.7] mm；p=0.002）较高，而斑块密度（42.1±19.6 比 50.6±20.4 HU；p=0.001）较低。颈动脉周围脂肪密度（OR：1.038，95%CI：1.023-1.053，p<0.001）被确定为有症状患者的独立预测因子。预测有症状患者的颈动脉周围脂肪密度最佳截断值估计为-74 HU（曲线下面积：0.753，95%CI：0.699-0.808，p<0.001）。颈动脉周围脂肪密度的观察者间一致性近乎完美（组内相关系数：0.818，95%CI：0.770-0.856，p<0.001）。
颈动脉周围脂肪密度可能是预测急性脑血管缺血事件的影像学生物标志物。
