Progress in multimodal imaging assessment of the correlation between perivascular adipose tissue and atherosclerosis.
Authors
Affiliations (10)
Affiliations (10)
- Department of Echocardiography, Shanghai General Hospital of Nanjing Medical University, Shanghai, P.R. China.
- Department of Ultrasound, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, 355 Luding Road, Putuo District, Shanghai, 200062, China.
- Fujian University of Traditional Chinese Medicine, Fujian, P.R. China.
- School of Medical Imaging, Shandong Second Medical University, Weifang, China.
- Department of Radiology, Mindong Hospital Affiliated to Fujian Medical University, Ningde, 355000, China.
- Department of Ultrasound, Guanghua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, P.R. China.
- Department of Echocardiography, Shanghai General Hospital of Nanjing Medical University, Shanghai, P.R. China. [email protected].
- Department of Ultrasound, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, 355 Luding Road, Putuo District, Shanghai, 200062, China. [email protected].
- Department of Echocardiography, Shanghai General Hospital of Nanjing Medical University, Shanghai, P.R. China. [email protected].
- Department of Echocardiography, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, 85 Wujin Road, Hongkou District, Shanghai, 200080, P.R. China. [email protected].
Abstract
Cardiovascular disease remains a leading cause of death and disability worldwide. Adipose tissue dysfunction is a key driver, and perivascular adipose tissue (PVAT) exerts location‑specific effects on the cardiovascular system. This review focuses on PVAT in atherosclerosis, with particular attention to pericoronary PVAT, epicardial adipose tissue (EAT), carotid PVAT, and peri-aortic adipose tissue (PAAT). PVAT homeostasis relies on UCP1‑mediated thermogenesis for metabolic modulation and on paracrine signaling via adiponectin and apelin. Under aging, obesity, or diabetes, PVAT switches from an anti‑inflammatory to a pro‑inflammatory phenotype, accelerating plaque formation through bidirectional inflammatory crosstalk. For clinical assessment, this review highlights progress in multimodal imaging technologies, including CT fat attenuation index, MRI water‑lipid separation, PET/CT, and echocardiography, for noninvasive quantification of PVAT density, composition, and metabolic activity, and compares their advantages and limitations. This review further discusses artificial intelligence (AI)-driven radiomic and radiotranscriptomic approaches that extend PVAT assessment beyond conventional single-parameter metrics. We systematically review the research progress of these techniques in evaluating dynamic PVAT changes and their correlation with atherosclerosis, aiming to clarify the intrinsic correlation between imaging‑derived PVAT functional status and AS development.