Dual-layer spectral detector CT to study the correlation between pericoronary adipose tissue and coronary artery stenosis

Background To investigate the relationship of pericoronary adipose tissue (PCAT) with coronary artery stenosis using dual-layer spectral detector CT (SDCT). Methods 99 patients were retrospectively divided into normal group, non-significant stenosis group and significant stenosis group (n = 33 in each group). Fat attenuation index (FAI) 40kev, spectral curve slope (λHU), effective atomic number (Eff-Z) and epicardial fat volume (EFV) were quantitatively evaluated of the narrowest part of the lesion tissue by SDCT. Results There were significant differences in PCAT parameters on SDCT (FAI40keV, λHU, Eff-Z and EFV) among the three groups ( P < 0.05). FAI40keV, λHU, and Eff-Z in significant stenosis group were statistically different from those in normal group and non-significant stenosis group ( P < 0.05). FAI40keV, λHU, and Eff-Z in non-significant stenosis group were statistically different from significant stenosis group ( P < 0.05). EFV in normal group were significantly lower in non-significant stenosis group and significant stenosis group ( P < 0.001). Univariate and multivariate logistic regression analyses identified FAI40keV (OR = 1.50, 95%CI 1.01 to 1.09) and λHU (OR = 6.81, 95%CI 1.87 to 24.86) as independent predictors of significant stenosis. FAI40keV and λHU had quite good discrimination, with an AUC of 0.84 and 0.80 respectively. Conclusion FAI40keV, λHU, and Eff-Z on SDCT in significant stenosis group were significantly different from normal and non-significant stenosis group while EFV in normal group were significantly different from non-significant stenosis group and significant stenosis group. FAI40kev and λHU were risk factors for significant stenosis.