Key result
Pericarotid fat stranding in acute stroke linked to ~336% greater risk of adverse short-term prognosis.
Why the study?
While perivascular fat stranding provides risk information in acute coronary syndrome, its clinical significance and relationship to short-term prognosis in acute stroke remained to be evaluated.
Is pericarotid fat stranding on CT angiography associated with worse short-term prognosis and larger infarct core volume in patients with acute ischemic stroke?
Observational (n=80)
Is pericarotid fat stranding on CT angiography associated with worse short-term prognosis and larger infarct core volume in patients with acute ischemic stroke?
Pericarotid fat stranding on CT angiography is a promising imaging marker associated with faster infarct core growth and worse short-term prognosis in acute ischemic stroke.
May flag higher-risk acute stroke on routine CTA; hypothesis-generating and requires prospective validation before clinical use.
PURPOSE: Perivascular epicardial fat stranding detected in the coronary computed tomography (CT) angiography is associated with culprit lesions and provides helpful information on the risk of acute coronary syndrome. This study aimed to evaluate the potential clinical significance of pericarotid fat stranding (PCFS) and investigate the association between PCFS and short-term prognosis in acute stroke using head and neck CT angiography (CTA). METHODS: This study included 80 patients (mean age, 69.69 ± 11.03; 58 men) who underwent both head and neck CTA and magnetic resonance imaging within a 1-week period. Baseline characteristics, pericarotid adipose tissue attenuation, plaque characteristics, ischemic penumbra, infarct core volume, infarct core growth rate (CGR), and the grade of collateral status were recorded and compared between a PCFS group and a non-PCFS group. Data were compared using the 2-sample t test, Mann-Whitney U test, Fisher exact test, and Spearman rank correlation analysis. RESULTS: We found that patients with PCFS had a significantly higher pericarotid adipose tissue density than patients without PCFS (-55.75 ± 5.53 vs -65.82 ± 9.65, P < 0.001). Patients with PCFS showed a larger infarct core volume (166.43 ± 73.07 vs 91.43 ± 55.03, P = 0.001) and faster CGR (39.57 ± 12.01 vs 19.83 ± 32.77; P < 0.001), and the frequency of adverse prognosis was more significant than in control participants (83.33% vs 19.11%). CONCLUSIONS: Individuals with PCFS showed higher CGR, which was substantially related to worse outcomes in patients with acute stroke with ipsilateral carotid atherosclerosis. Recognition of PCFS may help predict stroke prognosis and allow doctors to take early action to improve patient prognosis.
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Liu et al. (2023) conducted an observational in Acute ischemic stroke (n=80). Pericarotid fat stranding (PCFS) vs. No PCFS was evaluated on Adverse prognosis. Pericarotid fat stranding on CT angiography in acute stroke patients was associated with a higher frequency of adverse short-term prognosis compared to those without (83.33% vs 19.11%).
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