CTA源图像上颈动脉周围脂肪定量与斑块MRI易损特征的相关性研究  

Associations Between Pericarotid Fat Quantification on CTA Source Image and MRI⁃Based Characteristics of Vulnerable Plaque

作　　者：徐含波 余苗 孟闫凯 李中林 胡梦雪 王绍才 徐凯 XU Hanbo;YU Miao;MENG Yankai;LI Zhonglin;HU Mengxue;WANG Shaocai;XU Kai(Department of Radiology,the Affiliated Hospital of Xuzhou Medical University;Institute of Medical Imaging and Digital Medicine,Xuzhou Medical University;Department of Neurosurgery,the Affiliated Hospital of Xuzhou Medical University)

机构地区：[1]徐州医科大学附属医院影像科 [2]徐州医科大学医学影像与数字医学研究所 [3]徐州医科大学附属医院神经外科

出　　处：《中国医学计算机成像杂志》2024年第1期27-32,共6页Chinese Computed Medical Imaging

基　　金：徐州市自然科学基金项目(KC21066)。

摘　　要：目的:研究CT血管成像(CTA)源图像上颈动脉周围脂肪定量与斑块MRI易损特征的相关性。方法:回顾性分析2016年8月至2021年5月在徐州医科大学附属医院连续行颈动脉高分辨率MRI和颈动脉CTA检查的患者。选择颈动脉斑块最大的层面测量,在颈动脉周围脂肪组织、颈部皮下脂肪组织中分别测量平均颈动脉周围脂肪密度(PFD)和颈部皮下脂肪密度(CSFD),在同层面使用同种方法测量对侧(斑块或非斑块侧)的平均PFD、CSFD。根据颈动脉斑块MRI易损特征,即斑块内出血(IPH)、纤维帽变薄和/或破裂(TRFC)、富含脂质坏死核心(LRNC)进行分组,分析PFD、CSFD及PFD/CSFD与上述3个不同易损特征之间的相关性。结果:共纳入79例患者,平均年龄(61.2±10.1)岁。与非LRNC组相比,LRNC组斑块侧PFD/CSFD较低(P=0.010)。与非TRFC组相比,TRFC组斑块侧PFD较高(P=0.002)、PFD/CSFD较低(P=0.004)。与非IPH组相比,IPH组斑块侧PFD较高(P<0.001)、CSFD较高(P=0.013),而PFD/CSFD较低(P<0.001)。PFD、CSFD与IPH(P=0.004、P=0.016)显著相关。结论:PFD、CSFD及PFD/CSFD与颈动脉斑块易损特征具有一定相关性,其中PFD、CSFD与IPH显著相关,因此,PFD、CSFD有可能被用作斑块不稳定性的影像标志物。Purpose:To study the associations between pericarotid fat density(PFD)on CT angiography(CTA)source image and MRI-based characteristics of vulnerable plaque.Methods:We retrospectively evaluated consecutive patients who were undergone both high-resolution MRI and carotid artery CTA at the Affiliated Hospital of Xuzhou Medical University from August 2016 to May 2021.The section of the carotid artery with the largest carotid plaque was selected for measurement.Two separated regions of interest(ROI)were placed in the pericarotid fat tissue and cervical subcutaneous tissue to measure the mean value of pericarotid fat density(PFD)and cervical subcutaneous fat density(CSFD).The mean value of PFD,CSFD on the contralateral side(plaque or non-plaque side)were measured at the same axial using the same method.According to vulnerable carotid plaque characteristics(intraplaque hemorrhage[IPH],thinning and/or rupture of the fibrous cap[TRFC],lipid-rich necrotic core[LRNC]),the associations between PFD,CSFD,PFD/CSFD and three different risk characteristic were analyzed.Results:A total of 79 patients with a mean age of(61.2±10.1)years were included in this study.The plaque side PFD/CSFD was lower in the LRNC group when compared to the non-LRNC group(P=0.010).The plaque-side PFD was higher(P=0.002)and the plaque-side PFD/CSFD was lower(P=0.004)in the TRFC group when compared to the non-TRFC group.Both the plaque-side PFD(P<0.001)and the plaque-side CSFD(P=0.013)were higher and the plaque-side PFD/CSFD(P<0.001)was lower in the IPH subgroup when compared to the non-IPH group.PFD and CSFD were significantly correlated with IPH(P=0.004,P=0.016).Conclusion:PFD,CSFD and PFD/CSFD have a certain correlation with the vulnerability characteristics of carotid artery plaques.PFD and CSFD are significantly correlated with IPH,and therefore PFD and CSFD have the potential to be used as imaging marker of plaque instability.

关 键 词：高分辨率磁共振成像 颈动脉周围脂肪密度 颈部皮下脂肪密度 易损斑块 

分 类 号：R455.2[医药卫生—运动医学]