Associations between Pericarotid Fat Density Evaluated by CTA and Intraplaque Hemorrhage
Objective Evaluate the association between carotid peri adipoinflammation and intra plaque hemorrhage(IPH),and measure perivascular fat density(PFD)using computed tomography angiography(CTA)technology to reflect the inflammatory status of adipose tissue.Methods Collect clinical baseline and imaging data of patients who underwent continuous carotid artery CTA and carotid artery HR-MRI examinations in our hospital.Measure the lateral and contralateral PFD of the patient's carotid artery CTA plaque.Select the carotid artery segment with the most severe stenosis in each patient for analysis,calculate the plaque side PDF,non plaque side PDF,and the difference in PFD(△ PFD)between the two.According to the high-resolution MRI results of the carotid artery,patients were divided into two groups:the plaque hemorrhage group(IPH group)and the non plaque hemorrhage group(non IPH group).Compare the differences in clinical baseline data and PFD between two groups of patients.Statistical analysis was conducted using SPSS 26.0.First,the differences in plaque side and contralateral PFD between patients in the IPH and non IPH groups were evaluated using independent sample t-tests.Then,the differences in plaque side and contralateral PFD between the two groups were evaluated using paired sample t-tests.Finally,plaque side carotid PFD was included in binary logistic regression analysis and ROC curves were plotted.P＜0.05 indicates a statistically significant difference.Results This study included a total of 64 patients with an average age of(67.9±8.9)years.The PFD on the carotid artery plaque side of patients in the IPH group was higher than that in the non IPH group[(-44.21±14.75)HU vs(-64.87±13.25)HU],with statistical significance(P＜0.001).The △ PFD on the carotid artery of patients in the IPH group was higher than that in the non IPH group[(53.91±24.82)HU vs(35.88±14.52)HU],with statistical significance(P=0.001).The maximum plaque thickness in patients in the IPH group was higher than that in the non IPH group[(4.76±1.97)mm vs(3.88±1.49)mm],with statistical significance(P=0.046).The paired t-test results of two groups of patients showed that the mean PFD on the carotid plaque side of patients in the IPH group was higher than that on the contralateral side(-44.21±14.75)vs(-97.20±20.43),P＜0.001),while the mean PFD on the carotid plaque side of patients in the non IPH group was higher than that on the contralateral side(-64.87±13.25)vs(-99.14±11.21),P＜O.001]is also higher than the opposite side.Binary logistic regression analysis showed that after adjusting for confounding factors,there was a statistically significant difference in PFD on the carotid plaque side(OR=1.194,95％Cl:1.059～1.347)(P＜0.05).ROC curve analysis shows that the mean carotid artery PFD(area under the ROC curve(AUC)is 0.853,95％Cl:0.761～0.946,P＜0.001)has high predictive value for the occurrence of IPH.Conclusion There is a correlation between carotid artery PFD and carotid vulnerable plaque characteristic IPH,and PFD provides a basis for early prediction and risk stratification of IPH.
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