Evaluation of peri-plaque pericoronary adipose tissue attenuation in coronary atherosclerosis using a dual-layer spectral detector CT

Yulin Jia; Lei Zou; Ming Xue; Xiaoyu Zhang; Xigang Xiao

doi:10.3389/fmed.2024.1357981

Evaluation of peri-plaque pericoronary adipose tissue attenuation in coronary atherosclerosis using a dual-layer spectral detector CT

Front Med (Lausanne). 2024 Mar 11:11:1357981. doi: 10.3389/fmed.2024.1357981. eCollection 2024.

Authors

Yulin Jia¹, Lei Zou^{1

2}, Ming Xue¹, Xiaoyu Zhang¹, Xigang Xiao¹

Affiliations

¹ Department of Radiology, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
² Department of Radiology, Zigong Fourth People's Hospital, Zigong, China.

Abstract

Purpose: This study aimed to evaluate the differences between pericoronary adipose tissue (PCAT) attenuation at different measured locations in evaluating coronary atherosclerosis using spectral computed tomography (CT) and to explore valuable imaging indicators.

Methods: A total of 330 patients with suspicious coronary atherosclerosis were enrolled and underwent coronary CT angiography with dual-layer spectral detector CT (SDCT). Proximal and peri-plaque fat attenuation index (FAI) of stenosis coronary arteries were measured using both conventional images (CIs) and virtual monoenergetic images (VMIs) ranging from 40 keV to 100 keV. The slopes of the spectral attenuation curve (λ) of proximal and peri-plaque PCAT at three different monoenergetic intervals were calculated. Additionally, peri-plaque FAI on CI and virtual non-contrast images, and effective atomic number were measured manually.

Results: A total of 231 coronary arteries with plaques and lumen stenosis were finally enrolled. Peri-plaque FAI_CI and FAI_VMI were significantly higher in severe stenosis than in mild and moderate stenosis (p < 0.05), while peri-plaque λ, proximal FAI, and proximal λ were not statistically different. Proximal FAI, peri-plaque FAI, and peri-plaque λ were significantly higher in low-density non-calcified plaque (LD-NCP) and non-calcified plaque (NCP) than in calcified plaque (p < 0.01). Peri-plaque FAI was the highest in the LD-NCP group, while proximal FAI was the highest in the NCP group. In severe stenosis and in LD-NCP, peri-plaque FAI was significantly higher than proximal FAI (p < 0.05). The manually measured parameters related to peri-plaque PCAT attenuation had a positive correlation with the results of peri-plaque FAI measured automatically.

Conclusion: Peri-plaque PCAT has more value in assessing coronary atherosclerosis than proximal PCAT. Peri-plaque PCAT attenuation is expected to be used as a standard biomarker for evaluating plaque vulnerability and hemodynamic characteristics.

Keywords: coronary inflammation; dual-layer spectral detector CT; fat attenuation index; longitudinal location; pericoronary adipose tissue.

Grants and funding

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.