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Abstract：
UNASSIGNED: Magnetic resonance imaging (MRI) has the potential in assessing the inflammation of perivascular adipose tissue (PVAT) due to its excellent soft tissue contrast. However, evidence is lacking for the association between carotid PVAT measured by MRI and carotid vulnerable atherosclerotic plaques. This study aimed to investigate the association between signal intensity of PVAT and vulnerable plaques in carotid arteries using multi-contrast magnetic resonance (MR) vessel wall imaging.
UNASSIGNED: In this cross-sectional study, a total of 104 patients (mean age, 64.9±7.0 years; 86 men) with unilateral moderate-to-severe atherosclerotic stenosis referred to carotid endarterectomy (CEA) were recruited from April 2018 to December 2020 at Department of Neurosurgery of Peking University Third Hospital. All patients underwent multi-contrast MR vessel wall imaging including time-of-flight (ToF) MR angiography, black-blood T1-weighted (T1w) and T2-weighted (T2w) and simultaneous non-contrast angiography and intraplaque hemorrhage (IPH) imaging sequences. Patients with contraindications to endarterectomy or MRI examinations were excluded. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of PVAT were measured on ToF images and vulnerable plaque characteristics including IPH, large lipid-rich necrotic core (LRNC), and fibrous cap rupture (FCR) were identified. The SNR and CNR of PVAT were compared between slices with and without vulnerable plaque features using Mann-Whitney U test and their associations were analyzed using the generalized linear mixed model (GLMM).
UNASSIGNED: Carotid artery slices with IPH (30.93±14.56 vs. 27.34±10.02; P<0.001), FCR (30.35±13.82 vs. 27.53±10.37; P=0.006), and vulnerable plaque (29.15±12.52 vs. 27.32±10.05; P=0.016) had significantly higher value of SNR of PVAT compared to those without. After adjusting for clinical confounders, the SNR of PVAT was significantly associated with presence of IPH [odds ratio (OR) =0.627, 95% confidence interval (CI): 0.465-0.847, Puncorr=0.002, PFDR=0.016] and vulnerable plaque (OR =0.762, 95% CI: 0.629-0.924, Puncorr=0.006, PFDR=0.020). However, no significant association was found between the CNR of PVAT and presence of vulnerable plaque features (all P>0.05).
UNASSIGNED: The SNR of carotid artery PVAT measured by ToF MR angiography is independently associated with vulnerable atherosclerotic plaque features, suggesting that the signal intensity of PVAT might be an effective indicator for vulnerable plaque.
UNASSIGNED: In this cross-sectional study, a total of 104 patients (mean age, 64.9±7.0 years; 86 men) with unilateral moderate-to-severe atherosclerotic stenosis referred to carotid endarterectomy (CEA) were recruited from April 2018 to December 2020 at Department of Neurosurgery of Peking University Third Hospital. All patients underwent multi-contrast MR vessel wall imaging including time-of-flight (ToF) MR angiography, black-blood T1-weighted (T1w) and T2-weighted (T2w) and simultaneous non-contrast angiography and intraplaque hemorrhage (IPH) imaging sequences. Patients with contraindications to endarterectomy or MRI examinations were excluded. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of PVAT were measured on ToF images and vulnerable plaque characteristics including IPH, large lipid-rich necrotic core (LRNC), and fibrous cap rupture (FCR) were identified. The SNR and CNR of PVAT were compared between slices with and without vulnerable plaque features using Mann-Whitney U test and their associations were analyzed using the generalized linear mixed model (GLMM).
UNASSIGNED: Carotid artery slices with IPH (30.93±14.56 vs. 27.34±10.02; P<0.001), FCR (30.35±13.82 vs. 27.53±10.37; P=0.006), and vulnerable plaque (29.15±12.52 vs. 27.32±10.05; P=0.016) had significantly higher value of SNR of PVAT compared to those without. After adjusting for clinical confounders, the SNR of PVAT was significantly associated with presence of IPH [odds ratio (OR) =0.627, 95% confidence interval (CI): 0.465-0.847, Puncorr=0.002, PFDR=0.016] and vulnerable plaque (OR =0.762, 95% CI: 0.629-0.924, Puncorr=0.006, PFDR=0.020). However, no significant association was found between the CNR of PVAT and presence of vulnerable plaque features (all P>0.05).
UNASSIGNED: The SNR of carotid artery PVAT measured by ToF MR angiography is independently associated with vulnerable atherosclerotic plaque features, suggesting that the signal intensity of PVAT might be an effective indicator for vulnerable plaque.
摘要：
■磁共振成像（MRI）由于其出色的软组织对比度而具有评估血管周围脂肪组织（PVAT）炎症的潜力。然而,MRI测量的颈动脉PVAT与颈动脉易损动脉粥样硬化斑块之间缺乏相关性的证据.本研究旨在使用多对比磁共振（MR）血管壁成像研究PVAT信号强度与颈动脉易损斑块之间的关系。
■在这项横断面研究中，共有104名患者(平均年龄，64.9±7.0岁；2018年4月至2020年12月，北京大学第三医院神经外科招募了86名男性）患者，因颈动脉内膜切除术（CEA）而出现单侧中重度动脉粥样硬化性狭窄。所有患者均接受多对比MR血管壁成像，包括飞行时间（ToF）MR血管造影，黑血T1加权（T1w）和T2加权（T2w）以及同时非对比造影血管造影和斑块内出血（IPH）成像序列。排除有动脉内膜切除术或MRI检查禁忌症的患者。在ToF图像和包括IPH在内的易损斑块特征上测量PVAT的信噪比（SNR）和对比噪声比（CNR）。大的富含脂质的坏死核心（LRNC），并确定了纤维帽破裂（FCR）。使用Mann-WhitneyU检验比较有和没有易损斑块特征的切片之间的PVAT的SNR和CNR，并使用广义线性混合模型（GLMM）分析它们的关联。
■具有IPH的颈动脉切片（30.93±14.56vs.27.34±10.02；P<0.001），FCR(30.35±13.82vs.27.53±10.37;P=0.006),和易损斑块（29.15±12.52vs.27.32±10.05；P=0.016）与无PVAT相比，PVAT的SNR值明显更高。在调整了临床混杂因素后，PVAT的SNR与IPH[比值比(OR)=0.627,95%置信区间(CI):0.465~0.847,Puncorr=0.002,PFDR=0.016]和易损斑块(OR=0.762,95%CI:0.629~0.924,Puncorr=0.006,PFDR=0.020)的存在显著相关.然而,PVAT的CNR与易损斑块特征之间无显著相关性(均P>0.05)。
■通过ToFMR血管造影测量的颈动脉PVAT的SNR与易损的动脉粥样硬化斑块特征独立相关，提示PVAT的信号强度可能是易损斑块的有效指标。
■在这项横断面研究中，共有104名患者(平均年龄，64.9±7.0岁；2018年4月至2020年12月，北京大学第三医院神经外科招募了86名男性）患者，因颈动脉内膜切除术（CEA）而出现单侧中重度动脉粥样硬化性狭窄。所有患者均接受多对比MR血管壁成像，包括飞行时间（ToF）MR血管造影，黑血T1加权（T1w）和T2加权（T2w）以及同时非对比造影血管造影和斑块内出血（IPH）成像序列。排除有动脉内膜切除术或MRI检查禁忌症的患者。在ToF图像和包括IPH在内的易损斑块特征上测量PVAT的信噪比（SNR）和对比噪声比（CNR）。大的富含脂质的坏死核心（LRNC），并确定了纤维帽破裂（FCR）。使用Mann-WhitneyU检验比较有和没有易损斑块特征的切片之间的PVAT的SNR和CNR，并使用广义线性混合模型（GLMM）分析它们的关联。
■具有IPH的颈动脉切片（30.93±14.56vs.27.34±10.02；P<0.001），FCR(30.35±13.82vs.27.53±10.37;P=0.006),和易损斑块（29.15±12.52vs.27.32±10.05；P=0.016）与无PVAT相比，PVAT的SNR值明显更高。在调整了临床混杂因素后，PVAT的SNR与IPH[比值比(OR)=0.627,95%置信区间(CI):0.465~0.847,Puncorr=0.002,PFDR=0.016]和易损斑块(OR=0.762,95%CI:0.629~0.924,Puncorr=0.006,PFDR=0.020)的存在显著相关.然而,PVAT的CNR与易损斑块特征之间无显著相关性(均P>0.05)。
■通过ToFMR血管造影测量的颈动脉PVAT的SNR与易损的动脉粥样硬化斑块特征独立相关，提示PVAT的信号强度可能是易损斑块的有效指标。
