Different plaque types and its association with the volume and attenuation of pericoronary adipose tissue as assessed by coronary computed tomography angiography

Aim

To explore the relationship between different plaque types and pericoronary adipose tissue (PCAT) volume and attenuation values in patients with stable coronary artery disease (CAD) based on coronary computed tomographic angiography (CCTA).

Materials and Methods

Three hundred twenty one patients with stable CAD who underwent CCTA from May 2022 to March 2023 were enrolled. Using semi-automatic software, PCAT volumes and CT attenuation values were measured around the plaque and in the segment and proximal coronary artery where the plaque was located. To compare whether there was a statistical difference in PCAT volume and attenuation values among different plaque types in the periplaque, the segment, and proximal coronary artery in which the plaque was positioned.

Results

In total, 552 lesions were included, with 299 calcified plaques (CPs), 174 noncalcified plaques (NCPs), and 79 mixed plaques (MPs). There were excellent agreements between the two radiologists regarding the measured PCAT volumes and attenuation values (all interclass correlation coefficients values > 0.80). The periplaque PCAT volume was larger in CPs and MPs than in NCPs (291.98[213.25,381.03] mm³ vs. 261.00[173.25,377.85] mm³ vs. 206.54[139.72,284.07] mm³, P < 0.05), and the PCAT attenuation values around the plaque and the segment in which the plaque was positioned were higher in NCPs and MPs compared with CPs (-73.00[-79.00,-68.00] HU vs. -76.00[-79.00,-71.00] HU vs. -85.00[-92.00,-80.00] HU, -81.72 ± 0.70 HU vs. –80.73 ± 1.03 HU vs. -84.31 ± 0.49 HU; P < 0.05).

Conclusion

PCAT volume and attenuation values differed significantly among different plaque types, and the differences are particularly significant in measurements around the plaque.