Yu Shuwan, Huo Ran, Chen Xueyi, Song Xiaowei, Qiao Huiyu, Ning Zihan, Xu Huimin, Yang Dandan, Meng Decheng, Xu Ning, Lin Zixuan, Liu Ying, Zhao Xihai
Center for Biomedical Imaging Research, School of Biomedical Engineering, Tsinghua University, Beijing, China (S.Y., N.X., X.Z.).
Department of Radiology, Peking University Third Hospital, Beijing, China (R.H., H.X., D.M., Y.L.).
Arterioscler Thromb Vasc Biol. 2025 Aug;45(8):1440-1447. doi: 10.1161/ATVBAHA.125.322687. Epub 2025 Jun 5.
This study aimed to explore the association between the amount of carotid artery perivascular adipose tissue (PVAT) quantified by magnetic resonance imaging and prior cerebral infarction.
A total of 139 patients (mean age, 64.4±8.2 years; 112 men) with moderate-to-severe atherosclerotic stenosis referred to carotid endarterectomy were included and underwent multicontrast magnetic resonance vessel wall and brain imaging. The amount of carotid artery PVAT with vulnerable plaque components on magnetic resonance images of each patient was quantitatively analyzed, and the measurements included the average PVAT area, PVAT area index, and PVAT volume index. The amount measurements of PVAT at slices with vulnerable plaque between patients with and without prior cerebral infarction were compared. Logistic regression analyses were conducted to determine the association between the amount measurements of PVAT and prior cerebral infarction.
Patients with prior cerebral infarction showed significantly higher PVAT area, PVAT area index, and PVAT volume index compared with those without (all <0.01). The carotid PVAT area (odds ratio [OR], 1.015 [95% CI, 1.003-1.028]; =0.018), PVAT area index (OR, 2.051 [95% CI, 1.084-3.880]; =0.027), and PVAT volume index (OR, 2.864 [95% CI, 1.343-6.108]; =0.006) on the index side were significantly associated with prior cerebral infarction in univariate logistic regression. After adjusting for clinical confounding factors and plaque features, the associations between carotid PVAT area (OR, 1.028 [95% CI, 1.008-1.048]; =0.006), PVAT area index (OR, 3.587 [95% CI, 1.451-8.870]; =0.006), and PVAT volume index (OR, 6.053 [95% CI, 2.048-17.889]; =0.001) and prior cerebral infarction remained statistically significant.
The amount of PVAT in carotid artery with vulnerable plaques is independently associated with prior cerebral infarction and may, therefore, be related to the occurrence of ischemic stroke.
本研究旨在探讨通过磁共振成像定量分析的颈动脉血管周围脂肪组织（PVAT）量与既往脑梗死之间的关联。
纳入139例因中度至重度动脉粥样硬化狭窄而接受颈动脉内膜切除术的患者（平均年龄64.4±8.2岁；男性112例），并对其进行多对比磁共振血管壁和脑部成像检查。对每位患者磁共振图像上具有易损斑块成分的颈动脉PVAT量进行定量分析，测量指标包括PVAT平均面积、PVAT面积指数和PVAT体积指数。比较有和无既往脑梗死患者在易损斑块层面的PVAT量测量值。进行逻辑回归分析以确定PVAT量测量值与既往脑梗死之间的关联。
与无既往脑梗死的患者相比，有既往脑梗死的患者PVAT面积、PVAT面积指数和PVAT体积指数显著更高（均P<0.01）。在单因素逻辑回归中，患侧颈动脉PVAT面积（比值比[OR]，1.015[95%置信区间，1.003 - 1.028]；P = 0.018）、PVAT面积指数（OR，2.051[95%置信区间，1.084 - 3.880]；P = 0.027）和PVAT体积指数（OR，2.864[95%置信区间，1.343 - 6.108]；P = 0.006）与既往脑梗死显著相关。在调整临床混杂因素和斑块特征后，颈动脉PVAT面积（OR，1.028[95%置信区间，1.008 - 1.048]；P = 0.006）、PVAT面积指数（OR，3.587[95%置信区间，1.451 - 8.870]；P = 0.006）和PVAT体积指数（OR，6.053[95%置信区间，2.048 - 17.889]；P = 0.001）与既往脑梗死之间的关联仍具有统计学意义。
具有易损斑块的颈动脉PVAT量与既往脑梗死独立相关，因此可能与缺血性卒中的发生有关。
