冠状动脉血管周围脂肪组织多参数预测冠状动脉斑块易损性的可行性研究  

Feasibility study of multi-parameters prediction of vulnerability of coronary plaque based on perivascular adipose tissue

作　　者：刘艺超[1] 王超[1] 邱晓晖[1] LIU Yichao;WANG Chao;QIU Xiaohui(Imaging Center,the People’s Hospital of Bozhou,Bozhou,Anhui Province 236800,China)

机构地区：[1]亳州市人民医院影像中心,安徽亳州236800

出　　处：《实用放射学杂志》2024年第8期1267-1271,共5页Journal of Practical Radiology

基　　金：亳州市卫生健康委员会科研项目(bzwj2023c016)。

摘　　要：目的探讨冠状动脉斑块易损性与冠状动脉血管周围脂肪组织(PVAT)相关参数及PVAT参数预测易损斑块的可行性。方法回顾性分析199例临床怀疑冠心病接受冠状动脉CT血管成像(CCTA)检查患者的病变血管230支,分析斑块230处。评估斑块易损性、血管狭窄程度,测量冠状动脉周围脂肪衰减指数(FAI)值、冠状动脉周围脂肪体素总体积(FV)、冠状动脉周围非脂肪衰减指数(non-FAI)值,并计算血管周围表征指数(VPCI)。统计分析斑块易损性与PVAT参数之间的关系,并通过PVAT参数预测易损斑块。结果非易损斑块易引起轻、中度狭窄,易损斑块易引起重度狭窄,差异有统计学意义(P<0.001,P=0.001)。易损斑块组FAI、non-FAI及VPCI值高于非易损斑块组,FV值低于非易损斑块组,差异均有统计学意义(P<0.01)。易损斑块组FAI值高于non-FAI值,差异有统计学意义(P<0.01),而非易损斑块组FAI、non-FAI间差异无统计学意义(P>0.05)。FAI值、non-FAI值、VPCI值、FV值及4种参数联合预测易损斑块的诊断效能分别为0.753、0.624、0.770、0.755及0.837。结论易损斑块的血管重度狭窄率、FAI、non-FAI、VPCI值高于非易损斑块,FV值低于非易损斑块。PVAT相关参数具有预测易损斑块的价值。Objective To explore the relationship between the vulnerability of coronary plaques and parameters of perivascular adipose tissue(PVAT),and to assess the feasibility of predicting vulnerable plaques based on PVAT-related parameters.Methods A retrospective analysis was conducted on 199 patients,who were clinically suspected of coronary heart disease and underwent coronary computed tomography angiography(CCTA)examination,with a total of 230 lesion vessels and 230 plaques were analyzed.The vulnerability of plaques and the degree of vascular stenosis were evaluated.The pericoronary fat attenuation index(FAI),pericoronal fat total volume of voxels(FV)and pericoronary non-fat attenuation index(non-FAI)were measured,and the volumetric perivascular characterization index(VPCI)was calculated.The relationship between plaque vulnerability and PVAT parameters was statistically analyzed,and vulnerable plaques were predicted based on PVAT parameters.Results Non-vulnerable plaques were more likely to cause mild and moderate stenosis than vulnerable plaques,vulnerable plaques were more likely to cause severe stenosis than non-vulnerable plaques(P<0.001,P=0.001).The FAI,non-FAI,and VPCI values of the vulnerable plaque group were higher than those of the non-vulnerable plaque group,while the FV value was lower than that of the non-vulnerable plaque group,and the differences were statistically significant(P<0.01).The FAI value of the vulnerable plaque group was higher than the non-FAI value,with a statistically significant difference(P<0.01),while there was no statistically significant difference between the FAI and non-FAI of the non-vulnerable plaque group(P>0.05).The diagnostic efficiency of FAI,non-FAI,VPCI,FV values and the combined application of the four parameters for predicting vulnerable plaques were 0.753,0.624,0.770,0.755 and 0.837,respectively.Conclusion The occurrence rate of severe vascular stenosis,FAI,non-FAI,and VPCI values of vulnerable plaques are higher than those of non-vulnerable plaques,while the FV value is

关 键 词：冠状动脉CT血管成像 易损斑块 血管周围脂肪组织 

分 类 号：R543.3[医药卫生—心血管疾病] R814.42[医药卫生—内科学]