Perivascular Epicardial Fat Stranding at Coronary CT Angiography: A Marker of Acute Plaque Rupture and Spontaneous Coronary Artery Dissection.
Perivascular Epicardial Fat Stranding at Coronary CT Angiography: A Marker of Acute Plaque Rupture and Spontaneous Coronary Artery Dissection.
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DOI：
10.1148/radiol.2017171568
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发表时间：
2018-06
期刊：
影响因子：
19.7
通讯作者：
Ghoshhajra B
中科院分区：
文献类型：
--
作者：
Hedgire S;Baliyan V;Zucker EJ;Bittner DO;Staziaki PV;Takx RAP;Scholtz JE;Meyersohn N;Hoffmann U;Ghoshhajra B
评价疑似急性冠状动脉综合征（ACS）患者冠状动脉计算机断层扫描（CT）血管造影片上血管周围脂肪绞连的频率和意义。这项回顾性登记研究得到了机构审查委员会的批准。作者回顾了2012年2月至2016年3月在急诊科接受冠状动脉CT血管造影术的1403例连续患者（796例男性，607例女性;平均年龄52.8岁）的病历和图像。测量脂肪衰减、受累节段的圆周象限长度和数量以及未受影响的心外膜和皮下脂肪的衰减值。“病例”定义为血管周围脂肪绞合的患者。有显著狭窄但无脂肪绞合的患者被视为对照受试者。通过双样本t检验、Mann-Whitney U检验和Fisher检验比较病例组和对照组的基线影像学特征、ACS频率和后续下游检测结果。在11名受试者中观察到血管周围脂肪束，9名患有动脉粥样硬化病变，2名患有自发性冠状动脉夹层，平均脂肪束长度为19.2 mm，周向范围平均为2.9个象限。血管周围脂肪束、正常心外膜脂肪和正常皮下脂肪的平均衰减分别为17、−93.2和−109.3 HU（P < .001）。病例组与对照组之间的显著差异（P <0.05）包括较低的Agatston评分、室壁运动异常的存在以及血清肌钙蛋白水平的初始升高。病例组ACS发生率为45.4%，对照组为3.8%（P = 0.001）。在严重狭窄或自发性冠状动脉夹层的患者中，识别血管周围脂肪束可能是罪犯病变的一个有用的额外预测因子和ACS风险的标志物。
To evaluate the frequency and implications of perivascular fat stranding on coronary computed tomography (CT) angiograms obtained for suspected acute coronary syndrome (ACS). This retrospective registry study was approved by the institutional review board. The authors reviewed the medical records and images of 1403 consecutive patients (796 men, 607 women; mean age, 52.8 years) who underwent coronary CT angiography at the emergency department from February 2012 to March 2016. Fat attenuation, length and number of circumferential quadrants of the affected segment, and attenuation values in the unaffected epicardial and subcutaneous fat were measured. “Cases” were defined as patients with perivascular fat stranding. Patients with significant stenosis but without fat stranding were considered control subjects. Baseline imaging characteristics, ACS frequency, and results of subsequent downstream testing were compared between cases and control subjects by using two-sample t, Mann-Whitney U, and Fisher tests. Perivascular fat stranding was seen in 11 subjects, nine with atherosclerotic lesions and two with spontaneous coronary artery dissections, with a mean fat stranding length of 19.2 mm and circumferential extent averaging 2.9 quadrants. The mean attenuation of perivascular fat stranding, normal epicardial fat, and normal subcutaneous fat was 17, −93.2, and −109.3 HU, respectively (P < .001). Significant differences (P < .05) between cases and control subjects included lower Agatston score, presence of wall motion abnormality, and initial elevation of serum troponin level. ACS frequency was 45.4% in cases and 3.8% in control subjects (P = .001). Recognition of perivascular fat stranding may be a helpful additional predictor of culprit lesion and marker of risk for ACS in patients with significant stenosis or spontaneous coronary artery dissection.
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影响因子：
5.4
作者：
Meyersohn, Nandini M.;Szilveszter, Balint vi;Ghoshhajra, Brian B.
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