Association between spontaneous internal carotid artery dissection and perivascular adipose tissue attenuation on computed tomography angiography

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dc.contributor.authorCheng, Kevin
dc.contributor.authorLin, Andrew
dc.contributor.authorStecher, Ximena
dc.contributor.authorBernstein, Tomas
dc.contributor.authorZuniga, Paulo
dc.contributor.authorMazzon, Enrico
dc.contributor.authorBrunser, Alejandro
dc.contributor.authorDiaz, Violeta
dc.contributor.authorMartinez, Gonzalo
dc.contributor.authorCameron, William
dc.contributor.authorNicholls, Stephen J.
dc.contributor.authorPatel, Sanjay
dc.contributor.authorDey, Damini
dc.contributor.authorWong, Dennis T. L.
dc.contributor.authorVenturelli, Paula Munoz
dc.date.accessioned2025-01-20T20:17:19Z
dc.date.available2025-01-20T20:17:19Z
dc.date.issued2023
dc.description.abstractBackground: Spontaneous cervical artery dissection (sCAD) is a leading cause of ischemic stroke in young patients. Studies using high-resolution magnetic resonance imaging and positron emission tomography have suggested vessel wall inflammation to be a pathogenic factor in sCAD. Computed tomography (CT) attenuation of perivascular adipose tissue (PVAT) is an established non-invasive imaging biomarker of inflammation in coronary arteries, with higher attenuation values reflecting a greater degree of vascular inflammation. Objectives: We evaluate the CT attenuation of PVAT surrounding the internal carotid artery (PVAT(carotid)) with and without spontaneous dissection. Methods: Single-center prospective observational study of 56 consecutive patients with CT-verified spontaneous dissection of the internal carotid artery (ICA). Of these patients, six underwent follow-up computed tomography angiography (CTA). Twenty-two patients who underwent CTA for acute neurological symptoms but did not have dissection formed the control group. Using semi-automated research software, PVAT(carotid) was measured as the mean Hounsfield unit (HU) attenuation of adipose tissue within a defined volume of interest surrounding the ICA. Results: PVAT(carotid) was significantly higher around dissected ICA compared with non-dissected contralateral ICA in the same patients (-58.7 +/- 10.2 vs -68.9 +/- 8.1 HU, p < 0.0001) and ICA of patients without dissection (-58.7 +/- 10.2 vs -69.3 +/- 9.3 HU, p < 0.0001). After a median follow-up of 89 days, there was a significant reduction in PVAT(carotid) around dissected ICA (-57.5 +/- 13.4 to -74.3 +/- 10.5 HU, p < 0.05), while no change was observed around non-dissected contralateral ICA (-71.0 +/- 4.4 to -74.1 +/- 4.1 HU, p = 0.19). ICA dissection was an independent predictor of PVAT(carotid) following multivariable adjustment for age and the presence of ICA occlusion. Conclusion: PVAT(carotid) is elevated in the presence of sCAD and may decrease following the acute event.
dc.fuente.origenWOS
dc.identifier.doi10.1177/17474930231158538
dc.identifier.eissn1747-4949
dc.identifier.issn1747-4930
dc.identifier.urihttps://doi.org/10.1177/17474930231158538
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/92390
dc.identifier.wosidWOS:000942467900001
dc.issue.numero7
dc.language.isoen
dc.pagina.final838
dc.pagina.inicio829
dc.revistaInternational journal of stroke
dc.rightsacceso restringido
dc.subjectComputed tomography angiography
dc.subjectinternal carotid artery
dc.subjectspontaneous dissection
dc.subjectperivascular adipose tissue
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleAssociation between spontaneous internal carotid artery dissection and perivascular adipose tissue attenuation on computed tomography angiography
dc.typeartículo
dc.volumen18
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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