冠状动脉周围脂肪组织在不同斑块类型中的差异

Difference of Pericoronary Adipose Tissue in Different Plaque Types

目的探究不同斑块类型的冠状动脉周围脂肪组织(PCAT)的差异。资料与方法回顾性分析2020年3月—2021年6月在兰州大学第二医院经冠状动脉CT血管造影确诊为冠心病的488例患者共279个钙化斑块,其中153个非钙化斑块,56个混合斑块。分析一般临床资料、斑块位置及PCAT定量参数如体积、脂肪衰减指数(FAI)在不同斑块类型间的差异。采用受试者工作特征曲线评估FAI对不同斑块类型的诊断效能。结果不同斑块类型患者年龄、性别、体重指数、高危因素(吸烟、高血压、高血糖、高脂血症)及斑块位置差异无统计学意义(P均>0.05);非钙化斑块的PCAT体积小于钙化斑块及混合斑块(H=65.649,P<0.001);非钙化斑块及混合斑块的FAI大于钙化斑块[分别为−73.0(−80.0,−67.0)Hu、−76.5(−83.8,−70.0)Hu、−85.0(−92.0,−80.0)Hu;H=134.005,P<0.001)。使用FAI区分钙化和非钙化斑块的曲线下面积为0.821(95%CI 0.778~0.864),使用FAI区分钙化和混合斑块的曲线下面积为0.747(95%CI 0.675~0.818)。结论PCAT在不同斑块类型间存在差异,且随着冠状动脉粥样硬化进展,其FAI减低。

Purpose To investigate the differences of pericoronary adipose tissue(PCAT)among different plaque types.Materials and Methods The clinical and imaging data of 488 patients with a total of 279 calcified plaques,including 153 non-calcified plaques and 56 mixed plaques diagnosed with coronary artery disease by coronary CT angiography in Lanzhou University Second Hospital from March 2020 to June 2021 were retrospectively analyzed.General clinical data,plaque location and PCAT quantitative parameters such as volume,fat attenuation index(FAI)were analyzed for statistical differences among different plaque types.The diagnostic efficacy of FAI for different plaque types was evaluated by receiver operating characteristic curve.Results General clinical data such as age,gender,body mass index,risk factors(smoking,hypertension,hyperglycemia,hyperlipidemia),and plaque location of patients did not differ statistically significantly among plaque types(all P>0.05).The volume of PCAT in non-calcified plaques were significantly smaller than those in calcified plaques and mixed plaques(H=65.649,P<0.001).FAI values for non-calcified plaques and mixed plaques were significantly greater than those for calcified plaques[−73.0(−80.0,−67.0)Hu,−76.5(−83.8,−70.0)Hu,−85.0(−92.0,−80.0)Hu,respectively;H=134.005,P<0.001].The area under the curve using FAI values to differentiate calcified from non-calcified plaques was 0.821(95%CI 0.778−0.864),and the area under the curve using FAI values to differentiate calcified from mixed plaques was 0.747(95%CI 0.675-0.818).Conclusion PCAT differed between plaque types and its FAI values decrease as coronary atherosclerosis progressed.