Periaortic fat CT phenotypes linked to type B aortic dissection in case-control study

CT-derived periaortic fat phenotypes (fat attenuation index AUC 0.819; fragmentation index 0.716) associated with type B aortic dissection vs controls; aortic volume AUC 0.966 (95% CI 0.941-0.991). Exploratory; tear risk index not standalone.

• Retrospective case-control design included 100 patients with type B aortic dissection post primary thoracic endovascular aortic repair and 50 age/sex-matched controls; deep learning-assisted, radiologist-reviewed segmentation quantified multilayer periaortic adipose tissue.
• Interreader reproducibility was good for selected 3-mm periaortic adipose tissue measures (intraclass correlation coefficients 0.822-0.907).
• Principal case-control differences persisted after false discovery rate correction, but post-TEVAR differences and Tear Risk Index were not robust; findings are hypothesis generating.

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