Perivascular Fat Imaging by Computed Tomography: A Virtual Guide.

Kotanidis, Christos P; Antoniades, Charalambos

Imaging in medicine has been revolutionised following technological, computational and research advances over the past decades. Computed tomography (CT) in particular has seen rapid evolution, especially in the field of cardiovascular non-invasive imaging, as it is being recognised as the first-line tool for assessment of stable and unstable disease with diagnostic, prognostic and restratification potential. Vascular inflammation is a key component of the atherosclerotic process, and has been shown to induce molecular, transcriptional and structural changes to perivascular adipose tissue (PVAT). Being a diverse structure itself, PVAT surrounds the human vessels, and is characterised by a highly rich secretome, including amongst others adipokines, cytokines, gaseous messengers and miRNAs, and is implicated in a bi-directional interplay with the adjacent vascular wall, affecting and being affected by aspects of its biology, mainly inflammation. In this review we discuss the current status of cardiac CT in imaging vascular inflammation through perivascular adipose tissue phenotyping.