CCTA评估FAI指数与冠状动脉粥样硬化斑块的关系

Relationship between CCTA Evaluation of FAI Index and Coronary Atherosclerotic Plaque

目的基于冠状动脉CT血管成像(CCTA)评估脂肪衰减指数(FAI)与冠状动脉粥样硬化斑块的关系。方法回顾性收集2020年9月至2023年9月于我院接受CCTA检查的120例患者资料,根据冠状动脉有无斑块将其分为有斑块组(n=73)和无斑块组(n=47),基于CCTA图像使用智能辅助诊断系统测量冠状动脉周围FAI,分析有斑块组相应节段血管斑块特征及血管周围FAI值,并采用多元Logistic回归法分析二者间的关系。结果相较于无斑块组,有斑块组男性较多、年龄较大,且同时患糖尿病、高血压及高血脂的占比更高(P<0.05);两组体重指数和吸烟史比较差异无统计学意义(P>0.05)。有斑块组与无斑块组左前降支FAI值均高于左回旋支和右冠状动脉FAI值(P<0.05),且有斑块组左前降支FAI值明显高于无斑块组(P<0.05)。有斑块组中共有122支冠状动脉内存在斑块,斑块多为单发(55.74%)、钙化(49.18%)、局限性病变(84.43%),且多数血管狭窄程度超过50%(69.67%);不同斑块类型、病变范围间的血管周围FAI值比较差异均有统计学意义(P<0.05),不同斑块数量及血管狭窄程度的血管周围FAI值比较差异无统计学意义(P>0.05)。Logistic回归分析结果显示,斑块的分布血管、斑块类型和斑块病变范围均为影响FAI的独立性危险因素(P<0.05)。结论基于CCTA可定量评估FAI、冠状动脉粥样硬化斑块特征参数及血管狭窄程度,且斑块的分布血管、类型和病变范围可明显影响血管周围FAI值,临床中应加强对这类患者斑块进展的监测。

Objective To explore the relationship between coronary CT angiography(CCTA)evaluation of fat attenuation index(FAI)and coronary atherosclerotic plaque.Methods The data of 120 patients who underwent CCTA examination in our hospital were retrospectively collected from September 2020 to September 2023.According to the presence or absence of coronary plaque,they were divided into plaque group(n=73)and non-plaque group(n=47).Based on CCTA images,the intelligent auxiliary diagnosis system was used to measure the FAI around the coronary artery.The plaque characteristics and perivascular FAI values of the corresponding segments in plaque group were analyzed,and the relationship between them was analyzed by multivariate Logistic regression.Results Compared with non-plaque group,the plaque group had more men,older age,and higher proportions of diabetes mellitus,hypertension and hyperlipidemia(P<0.05).There were no statistical differences in body mass index and smoking history between the two groups(P>0.05).The FAI values of left anterior descending artery in plaque group and non-plaque group were higher than those of left circumflex artery and right coronary artery(P<0.05),and the FAI value of left anterior descending artery was significantly higher in plaque group than that in non-plaque group(P<0.05).There were 122 coronary arteries with plaques in plaque group,and plaques were mostly single(55.74%),calcified(49.18%)and localized lesions(84.43%),and the stenosis degree of most vessels was more than 50%(69.67%).There was a statistically significant difference in perivascular FAI value among different plaque types and lesion extents(P<0.05),and no statistical difference among different plaque counts and vascular stenosis degrees(P>0.05).Logistic regression analysis showed that the plaque vascular distribution,plaque type and plaque lesion extent were independent risk factors for FAI(P<0.05).Conclusion CCTA can quantitatively evaluate the FAI,characteristic parameters of coronary atherosclerotic plaque and degree of vascular stenosis.The plaque vascular distribution,type and lesion extent can significantly affect perivascular FAI value.The monitoring of plaque progression in such patients should be strengthened in clinical practice.