Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Assessing Abdominal Aortic Aneurysm Progression by Using Perivascular Adipose Tissue Attenuation on Computed Tomography Angiography

  • Shuai Zhang (Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong University) ;
  • Hui Gu (Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong University) ;
  • Na Chang (Department of Medical Technology, Jinan Nursing Vocational College) ;
  • Sha Li (Department of Clinical Medicine, Shandong Provincial Hospital, Shandong University) ;
  • Tianqi Xu (Department of Clinical Medicine, Shandong Provincial Hospital, Shandong University) ;
  • Menghan Liu (Depertment of Health Management, The First Affiliated Hospital of Shandong First Medical University) ;
  • Ximing Wang (Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong University)
  • Received : 2023.04.13
  • Accepted : 2023.07.11
  • Published : 2023.10.01
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Abstract

Objective: Recent studies have highlighted the active and potential role of perivascular adipose tissue (PVAT) in atherosclerosis and aneurysm progression, respectively. This study explored the link between PVAT attenuation and abdominal aortic aneurysm (AAA) progression using computed tomography angiography (CTA). Materials and Methods: This multicenter retrospective study analyzed patients with AAA who underwent CTA at baseline and follow-up between March 2015 and July 2022. The following parameters were obtained: maximum diameter and total volume of the AAA, presence or absence of intraluminal thrombus (ILT), maximum diameter and volume of the ILT, and PVAT attenuation of the aortic aneurysm at baseline CTA. PVAT attenuation was divided into high (> -73.4 Hounsfield units [HU]) and low (≤ -73.4 HU). Patients who had or did not have AAA progression during the follow-up, defined as an increase in the aneurysm volume > 10 mL from baseline, were identified. Kaplan-Meier and multivariable Cox regression analyses were used to investigate the association between PVAT attenuation and AAA progression. Results: Our study included 167 participants (148 males; median age: 70.0 years; interquartile range: 63.0-76.0 years), of which 145 (86.8%) were diagnosed with AAA accompanied by ILT. Over a median period of 11.3 months (range: 6.0-85.0 months), AAA progression was observed in 67 patients (40.1%). Multivariable Cox regression analysis indicated that high baseline PVAT attenuation (adjusted hazard ratio [aHR] = 2.23; 95% confidence interval [CI], 1.16-4.32; P = 0.017) was independently associated with AAA progression. This association was demonstrated within the patients of AAA with ILT subcohort, where a high baseline PVAT attenuation (aHR = 2.23; 95% CI, 1.08-4.60; P = 0.030) was consistently independently associated with AAA progression. Conclusion: Elevated PVAT attenuation is independently associated with AAA progression, including patients of AAA with ILT, suggesting the potential of PVAT attenuation as a predictive imaging marker for AAA expansion.

Keywords

Acknowledgement

The authors thank Mr. Jianqing Sun from the United Imaging Intelligence (Beijing) Co., Ltd. for providing us with software support and post-processing guidance.

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