Computed Tomography–Based Periaortic Adipose Tissue Imaging Phenotypes in Type B Aortic Dissection: A Retrospective Case–Control Study
6 affiliations
- 1Department of Radiology The First Affiliated Hospital of Guangxi Medical University Nanning Guangxi China
- 2Guangxi Key Laboratory of Genomic and Personalized Medicine Center for Genomic and Personalized Medicine, Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Guangxi Medical University Nanning Guangxi China
- 3Department of Vascular and Endovascular Surgery The First Affiliated Hospital of Guangxi Medical University Nanning Guangxi China
- 4Department of Public Health School of Medicine, Guangxi University of Science and Technology Liuzhou Guangxi China
- 5Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University Nanning Guangxi China
- 6Department of Occupational Health and Environmental Health School of Public Health, Guangxi Medical University Nanning Guangxi China
Abstract
Background: The periaortic microenvironment visible on routine computed tomography angiography remains incompletely characterized in type B aortic dissection (TBAD). We evaluated computed tomography angiography–based periaortic adipose tissue (PAAT) phenotypes associated with prevalent TBAD and explored a prespecified Tear Risk Index for post–thoracic endovascular aortic repair aortic dilation.
Methods: This retrospective case–control study included 100 patients with TBAD undergoing primary thoracic endovascular aortic repair and 50 normal controls frequency matched by age and sex. Deep learning–assisted, radiologist‐reviewed segmentation quantified multilayer PAAT and aortic morphology. Interreader reproducibility was assessed using intraclass correlation coefficients and Bland–Altman analyses. Group comparisons, receiver operating characteristic analyses, and adjusted logistic regression were performed.
Results: Compared with controls, patients with TBAD had larger aortic volume and higher 3‐mm PAAT volume, fat attenuation index, and fragmentation index. Aortic volume showed an area under the curve of 0.966 (95% CI, 0.941–0.991); corresponding values for 3‐mm PAAT volume, fat attenuation index, and fragmentation index were 0.614, 0.819, and 0.716, respectively. Interreader intraclass correlation coefficients for selected 3‐mm PAAT measures ranged from 0.822 to 0.907. Principal TBAD‐control PAAT findings remained supported after false discovery rate correction, whereas post–thoracic endovascular aortic repair PAAT differences were not robust. Tear Risk Index showed limited exploratory discrimination for dilation status.
Conclusions: Selected 3‐mm PAAT measures characterize a reproducible computed tomography angiography–based imaging phenotype associated with prevalent TBAD and may complement conventional aortic morphology. These findings are hypothesis generating, and Tear Risk Index should not be used as a standalone clinical predictor.
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BibTeX
@article{lei2026computed,
title = {{Computed Tomography–Based Periaortic Adipose Tissue Imaging Phenotypes in Type B Aortic Dissection: A Retrospective Case–Control Study}},
author = {Hao‐jie Lei and Guang‐ren Huang and Xing‐ning Mao and Zhong Qin and Xiao Qin and Jing Chen and Hai‐ying Zhang and Zi‐san Zeng and Qian‐hui Tang},
journal = {Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease},
year = {2026},
month = sep,
doi = {10.1161/jaha.126.051823},
url = {https://doi.org/10.1161/jaha.126.051823},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Computed Tomography–Based Periaortic Adipose Tissue Imaging Phenotypes in Type B Aortic Dissection: A Retrospective Case–Control Study
AU - Hao‐jie Lei
AU - Guang‐ren Huang
AU - Xing‐ning Mao
AU - Zhong Qin
AU - Xiao Qin
AU - Jing Chen
AU - Hai‐ying Zhang
AU - Zi‐san Zeng
AU - Qian‐hui Tang
PY - 2026
DA - 2026/09/29
JO - Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
DO - 10.1161/jaha.126.051823
UR - https://doi.org/10.1161/jaha.126.051823
AB - Background: The periaortic microenvironment visible on routine computed tomography angiography remains incompletely characterized in type B aortic dissection (TBAD). We evaluated computed tomography angiography–based periaortic adipose tissue (PAAT) phenotypes associated with prevalent TBAD and explored a prespecified Tear Risk Index for post–thoracic endovascular aortic repair aortic dilation. Methods: This retrospective case–control study included 100 patients with TBAD undergoing primary thoracic endovascular aortic repair and 50 normal controls frequency matched by age and sex. Deep learning–assisted, radiologist‐reviewed segmentation quantified multilayer PAAT and aortic morphology. Interreader reproducibility was assessed using intraclass correlation coefficients and Bland–Altman analyses. Group comparisons, receiver operating characteristic analyses, and adjusted logistic regression were performed. Results: Compared with controls, patients with TBAD had larger aortic volume and higher 3‐mm PAAT volume, fat attenuation index, and fragmentation index. Aortic volume showed an area under the curve of 0.966 (95% CI, 0.941–0.991); corresponding values for 3‐mm PAAT volume, fat attenuation index, and fragmentation index were 0.614, 0.819, and 0.716, respectively. Interreader intraclass correlation coefficients for selected 3‐mm PAAT measures ranged from 0.822 to 0.907. Principal TBAD‐control PAAT findings remained supported after false discovery rate correction, whereas post–thoracic endovascular aortic repair PAAT differences were not robust. Tear Risk Index showed limited exploratory discrimination for dilation status. Conclusions: Selected 3‐mm PAAT measures characterize a reproducible computed tomography angiography–based imaging phenotype associated with prevalent TBAD and may complement conventional aortic morphology. These findings are hypothesis generating, and Tear Risk Index should not be used as a standalone clinical predictor.
SN - 2047-9980
ER -