Data_Sheet_1_Association of Pericoronary Adipose Tissue Quality Determined by Dual-Layer Spectral Detector CT With Severity of Coronary Artery Disease: A Preliminary Study.DOCX

Background: Pericoronary adipose tissue (PCAT) is considered as a source of inflammatory mediators, leading to the development of coronary atherosclerosis. The study aimed to investigate the correlation between PCAT quality derived from dual-layer spectral detector CT (SDCT) and the severity of coronary artery disease (CAD), and whether PCAT parameters were independently associated with the presence of CAD.Materials and Methods: A total of 403 patients with symptoms of chest pain who underwent SDCT were included. PCAT quality including fat attenuation index (FAI) measured from conventional polychromatic CT images (FAI120kvp) and spectral virtual mono-energetic images at 40 keV (FAI40keV), slope of spectral HU curve (λHU), and effective atomic number (Eff-Z) were measured around the lesions representing the maximal degree of vascular stenosis in each patient. Meanwhile, overall epicardial adipose tissue (EAT) attenuation was acquired in the conventional polychromatic energy imaging.Results: FAI40keV, λHU, Eff-Z, and FAI120kvp increased along with the degree of CAD in general and were superior to the overall EAT attenuation for detecting the presence of CAD. Multivariate logistic regression analysis indicated that FAI40keV was the most powerful independent indicator (odds ratio 1.058, 95% CI 1.044–1.073; p < 0.001) of CAD among these parameters. Using an optimal cut-off (−131.8 HU), FAI40keV showed higher diagnostic accuracy of 80.6% compared with the other parameters.Conclusions: These preliminary findings suggest that FAI40keV on SDCT may be an appealing surrogate maker to allow monitoring of PCAT changes in the development of CAD.

背景：围冠脂肪组织（PCAT）被视为炎症介质的来源，从而导致冠状动脉粥样硬化的发生。本研究旨在探讨由双层光谱探测器计算机断层扫描（SDCT）获得的PCAT质量与冠状动脉疾病（CAD）严重程度之间的相关性，以及PCAT参数是否与CAD的存在具有独立相关性。研究材料与方法：共纳入403例出现胸痛症状并接受SDCT检查的患者。测量了PCAT质量，包括从常规多色CT图像（FAI120kvp）和40keV光谱虚拟单能图像中测量的脂肪衰减指数（FAI）、光谱HU曲线的斜率（λHU）和有效原子序数（Eff-Z），这些参数是在每个患者代表血管狭窄最大程度的病变周围测量的。同时，在常规多色能量成像中获取了总体心外膜脂肪组织（EAT）的衰减。结果：FAI40keV、λHU、Eff-Z和FAI120kvp随CAD程度的增加而增加，在检测CAD存在方面优于总体EAT衰减。多变量逻辑回归分析表明，FAI40keV是这些参数中最强有力的独立指标（优势比1.058，95%置信区间1.044–1.073；p < 0.001）。使用最佳截断值（−131.8 HU），与其它参数相比，FAI40keV显示出更高的诊断准确性，为80.6%。结论：这些初步结果表明，SDCT上的FAI40keV可能是一个有吸引力的替代标志物，允许监测CAD发展中PCAT的变化。