The Relationship Between Pericoronary Adipose Tissue And Plaque Features Was Evaluated By Spectral CT

Objective:The purpose of this study was to evaluate the relationship between pericoronary adipose tissue（PCAT）attenuation and plaque characteristics based on multi-parameter imaging by dual-layer spectral detector CT（SDCT）,and to investigate the potential value of PCAT parameters evaluated by SDCT in the diagnosis of high-risk coronary artery disease（CAD）.Research object and methods:A retrospective analysis of 329 patients with chest pain and suspected CAD who admitted to the First Hospital of Lanzhou University and underwent coronary computed tomography angiography（CCTA）from December 2021 to December 2022.According to the strict exclusion criteria,finally,the CCTA images of 126 patients were used to special software to measured PCAT attenuation at conventional imaging and VMI（40ke V and 70ke V）,andλHU,Eff-Z of PCAT.According to the degree of lumen stenosis,CT-Leaman score（CT-Le Sc）and plaque characteristics,to analyze the differences among the groups by SPSS 26.0statistical software.Pearson correlation tests were used to evaluate the correlation between PCAT parameters and CT-Le Sc.univariate and multifactorial logistics regression were used to explore the independent predictors of obstructive CAD and CT-Le Sc>5.Receiver operating characteristic（ROC）curve was used to evaluate the predictive efficacy of PCAT parameters on CT-Le Sc>5.Results:It is preliminarily suggested that SDCT is superior to conventional CT in detecting the pathological changes of PCAT during the occurrence and development of coronary atherosclerotic plaques.（1）PCAT parameters based on SDCT were significantly correlated with CAD obstruction,plaque lesion range and plaque burden,and PCAT_{40ke V},Eff-Z can identify large-range lesions and proximal segment lesions of coronary artery,respectively.（2）PCAT parameters based on SDCT had no significant correlation with plaque types,plaque lesion vessels and the number of involved vessels.（3）PCAT parameters based on SDCT,EAT attenuation and CT-Le Sc were positively correlated.（4）PCAT parameters based on SDCT were independently correlated with high plaque burden on CT-Le Sc,and PCAT_{40ke V}was considered to be an independent predictor.（5）In addition,the PCAT parameters of SDCT were also related to gender,alcohol history and hypertension.Conclusion:（1）The PCAT parameters of SDCT increase with the worsen of CAD obstruction degree,plaque lesion range and CT-Le Sc,and PCAT_{40ke V}is considered to be an independent predictor of high plaque burden.（2）Coronary artery inflammation is more severe in men.SDCT is superior to conventional CT in evaluating the correlation between coronary atherosclerotic plaque and PCAT,and can be more sensitive to recognize vascular inflammation.