Association Between the Amount of Carotid Perivascular Adipose Tissue and Prior Ischemic Stroke: An MR Imaging Study

BACKGROUND: This study aimed to explore the association between the amount of carotid artery perivascular adipose tissue (PVAT) quantified by magnetic resonance imaging and prior cerebral infarction. METHODS: A total of 139 patients (mean age, 64.4±8.2 years; 112 men) with moderate-to-severe atherosclerotic stenosis referred to carotid endarterectomy were included and underwent multicontrast magnetic resonance vessel wall and brain imaging. The amount of carotid artery PVAT with vulnerable plaque components on magnetic resonance images of each patient was quantitatively analyzed, and the measurements included the average PVAT area, PVAT area index, and PVAT volume index. The amount measurements of PVAT at slices with vulnerable plaque between patients with and without prior cerebral infarction were compared. Logistic regression analyses were conducted to determine the association between the amount measurements of PVAT and prior cerebral infarction. RESULTS: Patients with prior cerebral infarction showed significantly higher PVAT area, PVAT area index, and PVAT volume index compared with those without (all P <0.01). The carotid PVAT area (odds ratio [OR], 1.015 [95% CI, 1.003–1.028]; P =0.018), PVAT area index (OR, 2.051 [95% CI, 1.084–3.880]; P =0.027), and PVAT volume index (OR, 2.864 [95% CI, 1.343–6.108]; P =0.006) on the index side were significantly associated with prior cerebral infarction in univariate logistic regression. After adjusting for clinical confounding factors and plaque features, the associations between carotid PVAT area (OR, 1.028 [95% CI, 1.008–1.048]; P =0.006), PVAT area index (OR, 3.587 [95% CI, 1.451–8.870]; P =0.006), and PVAT volume index (OR, 6.053 [95% CI, 2.048–17.889]; P =0.001) and prior cerebral infarction remained statistically significant. CONCLUSIONS: The amount of PVAT in carotid artery with vulnerable plaques is independently associated with prior cerebral infarction and may, therefore, be related to the occurrence of ischemic stroke.