Pericarotid fat stranding at CT angiography:a marker of the short-term prognosis of acute ischemic stroke

Abstract Purpose Perivascular epicardial fat stranding detected in the coronary CT angiography was associated with culprit lesion and provided helpful information of risk for ACS. This study aimed to evaluate the potential clinical significance of pericarotid fat stranding (PCFS) and investigate the association between PCFS and short-term prognosis of acute stroke with head and neck CT angiography (CTA). Methods This study included 80 patients (mean age 69.69士11.03; 58 men) who underwent both head and neck CTA and magnetic resonance imaging (MRI) within 2 weeks. Baseline characteristics, PCAT attenuation, plaque characteristics, ischemic penumbra, infarct core volume, infarct core growth rate (CGR) and grade of collateral status between PCFS group and non-PCFS group were recorded, these data were compared by using two-sample t,Mann-Whitney U,Fisher tests and Spearman’s correlation test. Results We found that patients with PCFS had a significantly higher PCAT density than non-PCFS patients (-55.75 ± 5.53 vs -65.82 ± 9.65;P༜0.001 ). Those 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 that the frequency of adverse prognosis was more significant than in control subjects (83.33% vs 19.11%). The difference was statistically significant. Conclusions We discovered that individuals with PCFS had greater CGR, which was substantially related with a worse outcome in acute stroke patients with ipsilateral carotid atherosclerosis. Recognition of PCFS may help to predict stroke prognosis and allow doctors to take early action to improve patient prognosis.