ArticleJapanese journal of radiology2026
Perivascular fat attenuation index at internal carotid artery stenosis: a biomarker of perivascular adipose tissue (PVAT) inflammation.
Article in Japanese journal of radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesThe aim of our study was to evaluate the value of the fat attenuation index (FAI) as a tool for measuring plaque inflammation in perivascular adipose tissue (PVAT) and identifying symptomatic plaques in internal carotid atherosclerosis.
methodsWe conducted a retrospective analysis of patients with internal carotid atherosclerosis who underwent carotid artery computed tomography angiography (CTA). The patients were assigned to a symptomatic plaque group or asymptomatic plaque group on the basis of clinical diagnosis and neuroimaging. We measured perivascular FAIs at the maximum stenosis site with the plaque, the nonstenosis site adjacent to the maximum stenosis site, and the ipsilateral internal carotid artery (ICA). We subsequently compared these measurements between the two groups. Multivariable generalized estimating equation (GEE) analysis was performed to identify imaging predictors of symptomatic plaque in the ICA, and receiver operating characteristic (ROC) curves were used to assess the diagnostic accuracy for classifying symptomatic plaques.
resultsA total of 101 and 94 ICAs were included in the symptomatic plaque group and asymptomatic plaque group, respectively. Mild ICA stenosis resulted in a lower FAI at the maximum stenosis site than moderate or severe stenosis did (p = 0.001). A greater FAI of the ipsilateral ICA was observed in the symptomatic plaque group than in the asymptomatic plaque group (p = 0.002), as was the FAI at the maximum stenosis site of the ICA with the plaque (p = 0.038). Multivariable GEE analysis revealed that the stenosis severity (p = 0.004) and FAI at the maximum stenosis site of the ICA (p = 0.007) were capable of identifying symptomatic plaques. ROC analysis revealed that the FAI at the maximum stenosis site of the ICA, in combination with stenosis severity, resulted in a higher area under the curve (AUC) value (0.863) with moderate specificity (74%) and high sensitivity (89%).
conclusionThe perivascular FAI at the maximum stenosis site of the ICA is useful for identifying symptomatic plaques by monitoring inflammation in patients with ICA atherosclerosis, which may provide a new inflammation marker for risk stratification of patients with stroke.
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