ArticleInsights into imaging2026
Spectral CT parameters of perivascular adipose tissue as non-invasive biomarkers for identifying symptomatic carotid atherosclerosis.
Article in Insights into imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo evaluate the association between computed tomography (CT) spectral parameters of perivascular adipose tissue (PVAT) and carotid plaque composition, and to assess their value for identifying symptomatic plaques. MATERIALS AND
methodsIn this study, 306 consecutive patients with computed tomography angiography (CTA)-confirmed carotid atherosclerosis who underwent head and neck spectral CT angiography were analyzed. Quantitative plaque parameters and PVAT spectral metrics were extracted. Correlations between quantitative plaque parameters and PVAT spectral indices were analyzed, and logistic regression was used to identify independent predictors of symptomatic plaques. Diagnostic performance was evaluated by generating receiver operating characteristic (ROC) curves.
resultsCompared with asymptomatic patients, symptomatic carotid plaques showed higher PVAT effective atomic number (Zeff) and iodine concentration (IC) but lower fat fraction (FF) (all p < 0.05). Zeff and IC correlated positively with fibrous fatty and necrotic core volumes, whereas FF correlated negatively with necrotic core volume (all p < 0.001). In multivariable models, Zeff, IC, FF, and virtual monoenergetic image attenuation at 70 keV (CT
conclusionSpectral CT-derived PVAT parameters differ between symptomatic and asymptomatic carotid atherosclerosis and are associated with plaque composition, providing complementary noninvasive information for identifying symptomatic plaques. KEY POINTS: Question: Can spectral CT-derived PVAT parameters improve noninvasive identification of symptomatic carotid atherosclerosis beyond luminal stenosis?
findingsPVAT spectral parameters differed between symptomatic and asymptomatic plaques, and adding FF or CT
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