【摘要】 目的：探讨基于冠状动脉CT血管成像（CCTA）的冠状动脉周围脂肪衰减指数（FAI）与冠状动脉斑块定量参数的相关性。方法：前瞻性连续纳入因怀疑冠心病接受CCTA检查的250例患者，分析750支冠状动脉主干[左前降支（LAD）、左回旋支（LCX）、右冠状动脉（RCA）]。采用Revolution CT Victor256进行CCTA扫描，通过联影uAI平台获取冠状动脉疾病报告和数据系统（CAD-RADS）评分、节段狭窄评分（SSS）、节段累及评分（SIS），总斑块长度（TPL）、总斑块体积（TPV）、钙化斑块体积（CPV）、非钙化斑块体积（NCPV）、脂质斑块体积（LPV）及总斑块负荷（TPB%）等斑块定量参数，同时测量三大主干的FAI值，定义FAI≥-70.1 HU为阳性组。结果：115例患者的175支冠脉为FAI阳性组，两组间比较分析结果显示，FAI阳性组的CAD-RADS评分、SSS、SIS及TPL、TPV、CPV、NCPV、LPV、TPB%均显著高于FAI阴性组（P<0.01）。进一步的二元logistic回归分析显示，CAD-RADS评分（OR=1.79,P<0.01）和LPV(OR=1.03,P=0.01)是FAI阳性的独立危险因素；受试者工作特征（ROC）曲线分析显示，二者联合的ROC曲线下面积（AUC）=0.79。结论：冠周脂肪FAI与冠脉狭窄程度及LPV呈正相关，验证了冠周炎症与粥样硬化及斑块脂质成分的关联。更多还原

【Abstract】 Purpose: To investigate the correlation between the pericoronary fat attenuation index(FAI) derived from coronary computed tomography angiography(CCTA) and quantitative plaque parameters. Methods: This prospective study consecutively enrolled 250 patients with suspected coronary artery disease(CAD) who underwent CCTA, analyzing 750 major coronary arteries [left anterior descending(LAD), left circumflex(LCX), and right coronary artery(RCA)]. CCTA was performed using a Revolution CT Victor 256 scanner. Quantitative plaque parameters, including the Coronary Artery Disease Reporting and Data System(CAD-RADS) score, segment stenosis score(SSS), segment involvement score(SIS), total plaque length(TPL), total plaque volume(TPV), calcified plaque volume(CPV), non-calcified plaque volume(NCPV), lipid plaque volume(LPV), and total plaque burden(TPB%), were obtained using the United Imaging uAI platform. Pericoronary FAI was measured for the three major coronary arteries, with FAI ≥-70.1 HU defined as FAI-positive. Results: Among the cohort, 115 patients(175 arteries) were classified into the FAI-positive group. Comparative analysis revealed that the FAI-positive group had significantly higher CAD-RADS scores, SSS, SIS, TPL, TPV, CPV, NCPV, LPV, and TPB% compared to the FAInegative group(all P<0.01). Binary logistic regression analysis identified CAD-RADS score(OR=1.79, P<0.01) and LPV(OR=1.03, P=0.01) as independent risk factors for FAI positivity. Receiver operating characteristic(ROC) curve analysis demonstrated that the combination of these two predictors yielded an area under the curve(AUC) of 0.79.Conclusion: Pericoronary FAI shows a positive correlation with the severity of coronary stenosis and LPV, supporting the association between pericoronary inflammation, atherosclerosis, and lipid-rich plaque deposition.更多还原