基于计算机断层血管造影探讨颈动脉血管周围脂肪组织强化与斑块易损特征之间的关系OACSTPCD

Objective To investigate the relationship between enhancement of perivascular adipose tissue(PVAT)and computed tomographic angiography(CTA)features of vulnerable plaques in carotid arteries.Methods A total of 86 patients who underwent carotid CTA with delayed scanning from July 2022 to August 2023 at the Second Affiliated Hospital of Zhejiang Chinese Medicine University were included.Patients were divided into symptomatic group(42 cases)and asymptomatic group(44 cases)based on clinical and imaging manifestations.Differences in CTA characteristics of carotid plaques(plaque type,plaque surface morphology,plaque thickness,and plaque enhancement rate),perivascular fat density(PFD),and PVAT enhancement rate between the two groups were analyzed,as well as the correlation between the characteristics of carotid vulnerable plaque and PVAT enhancement rate.Results Plaque enhancement rate was positively correlated with PVAT enhancement rate,with a stronger correlation at the delayed scan than at the conventional arterial phase(r=0.328,0.284;P<0.05).In the symptomatic group,plaque enhancement rate at the delayed scan was moderately correlated with PVAT enhancement rate(r=0.439,P<0.05).Plaque thickness,plaque enhancement rate at the conventional arterial phase,plaque enhancement rate at the delayed scan,PVAT enhancement rate at the conventional arterial phase,and PVAT enhancement rate at the delayed scan in the symptomatic group were higher than those in the asymptomatic group(Z=-2.207,-2.410,-2.376,-2.773,-3.352;P<0.05).There was good consistency between two observers in the assessment of plaque characteristics.Conclusion CTA delayed scanning can improve the accuracy of plaque density and PFD measurement,which may partially compensate for the shortcomings of conventional carotid CTA.The correlation between PVAT enhancement rate and vulnerable plaque enhancement rate not only provides important clues for the assessment of plaque vulnerability,but may also have predictive and evaluative value for the occurrence of ischemic stroke.