颈动脉周围脂肪衰减指数与缺血性脑卒中的关系

Relationship between carotid fat attenuation index and ischemic stroke

目的 评估颈动脉周围脂肪炎症与缺血性脑卒中的关系。方法 筛选2021-01—2022-09郑州大学第五附属医院的248例受试者,按近6个月内有无发生过颈动脉供血区域脑梗死或TIA分为有症状组(n=89)和无症状组(n=159)。症状组选择症状侧颈动脉狭窄最严重的斑块,无症状组选择颈动脉狭窄最严重的斑块,通过CT血管造影(CTA)评估斑块段内周围脂肪衰减指数(FAI)与无症状组最狭窄一侧的颈动脉周围FAI。应用Logistic回归分析和受试者工作特征(ROC)分析FAI与缺血性脑卒中的关系。结果 有症状组的FAI值高于无症状组[(-49.0±10.7)Hu比(-64.1±18.7)Hu,P<0.001]。二元Logistic回归分析显示,调整混杂因素后颈动脉FAI与缺血性脑卒中密切相关(OR=1.078,95%CI:1.053~1.103,P<0.01),ROC曲线显示曲线下面积(AUC)为0.761。结论 症状组颈动脉周围FAI增加,颈部斑块相关的炎症反应已延伸至血管周围脂肪组织(PVAT),颈动脉周围脂肪组织的炎症反应可通过颈部CTA识别。

Objective To evaluate the relationship between periarterial fat inflammation and ischemic stroke.Methods A total of 248 subjects in the Fifth Affiliated Hospital of Zhengzhou University from January 2021 to September 2022 were screened.The patients were divided into symptomatic group and asymptomatic group based on whether they had experienced ischemic stroke related to carotid artery narrowing within the past 6 months.The head-neck combined CTA images were analyzed using DICOM artificial intelligence vascular analysis software to obtain the target carotid artery FAI value.The correlation between FAI and symptomatic carotid artery narrowing was analyzed by constructing a multivariate Logistic regression model and ROC curve.Results The FAI value in the symptomatic group(n=89)was higher than that in the asymptomatic group(n=159)((-49.0±10.7)Hu vs(-64.1±18.7)Hu,P<0.001).After adjusting for confounding factors,such as gender,hypertension,age,diabetes,coronary heart disease,and the degree of artery stenosis,Logistic regression analysis showed that carotid FAI(OR=1.078,95%CI:1.053-1.103,P<0.01)was independently associated with ischemic stroke.The receiver operating characteristic curve showed the AUC value was 0.761.Conclusion In the symptomatic group,the FAI around the carotid artery is increased,and the inflammation associated with cervical plaque is extended to the perivascular adipose tissue(PVAT).The inflammation in the pericarotid adipose tissue could be identified by CTA of the neck.