Expanding the Radiologist’s Arsenal against Abdominal Aortic Aneurysms, a Versatile Adversary

Mitsouras, Dimitrios; Leach, Joseph

doi:10.1148/radiol.2020200531

Cited by 4 publications

(4 citation statements)

References 11 publications

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“…For instance, Hori et al reported that the postoperative pulse wave velocity was significantly and independently associated with AAA sac growth, and Welborn et al found that AAA sac shrinkage was significantly associated with a larger graft-to-aortic apposition surface area 17,30 . In a recent J o u r n a l P r e -p r o o f 14 editorial, Mitsouras and Leach also highlight that combined assessment of possible predicting parameters is a promising and important tool 37 . Aside from knowledge on predictors of AAA sac remodeling, it is likely to also improve understanding of the underlying disease process of AAA progression.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of anatomic predictors of abdominal aortic aneurysm remodeling after endovascular repair

Rijswijk

Jebbink

Zeebregts

et al. 2022

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 99%

A systematic review of anatomic predictors of abdominal aortic aneurysm remodeling after endovascular repair

Rijswijk

Jebbink

Zeebregts

et al. 2022

Journal of Vascular Surgery

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“…The 30 AAA patients in this study comprised 24 males and 6 females, with a mean age 71.9 ± 7.9 years. The mean and inter-quartile range of the interval between non-contrast MRI and CTA were 6.4 ± 12.5 days and [1,4] days, respectively, with the majority of patients (>85 %) having MRI and CTA less than one month apart. It was assumed there was no significant change in AAA diameter and volume over this relatively short time interval, since the majority of the cases in this study cohort were asymptomatic with relatively small aneurysm sizes (Table 1).…”

Section: Resultsmentioning

confidence: 97%

“…The risk of rupture increases with increasing AAA diameter [2], and current guidelines recommend repair (surgical or endovascular) of asymptomatic AAA when maximum diameter exceeds 5.4 cm or the growth rate exceeds 1 cm per year [3]. Population-wide screening programs are the only approach toward reducing AAA mortality [4] and many patients with a small AAA now undergo yearly surveillance.…”

Section: Introductionmentioning

confidence: 99%

Computer-aided quantification of non-contrast 3D black blood MRI as an efficient alternative to reference standard manual CT angiography measurements of abdominal aortic aneurysms

Wang

Tian

Xiong

et al. 2021

European Journal of Radiology

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Background: Non-contrast 3D black blood MRI is a promising tool for abdominal aortic aneurysm (AAA) surveillance, permitting accurate aneurysm diameter measurements needed for patient management. Purpose: To evaluate whether automated AAA volume and diameter measurements obtained from computeraided segmentation of non-contrast 3D black blood MRI are accurate, and whether they can supplant reference standard manual measurements from contrast-enhanced CT angiography (CTA). Materials and Methods: Thirty AAA patients (mean age, 71.9 ± 7.9 years) were recruited between 2014 and 2017. Participants underwent both non-contrast black blood MRI and CTA within 3 months of each other. Semiautomatic (computer-aided) MRI and CTA segmentations utilizing deformable registration methods were compared against manual segmentations of the same modality using the Dice similarity coefficient (DSC). AAA lumen and total aneurysm volumes and AAA maximum diameter, quantified automatically from these segmentations, were compared against manual measurements using Pearson correlation and Bland-Altman analyses. Finally, automated measurements from non-contrast 3D black blood MRI were evaluated against manual CTA measurements using the Wilcoxon test, Pearson correlation and Bland-Altman analyses. Results: Semi-automatic segmentations had excellent agreement with manual segmentations (lumen DSC: 0.91 ± 0.03 and 0.94 ± 0.03; total aneurysm DSC: 0.92 ± 0.02 and 0.94 ± 0.03, for black blood MRI and CTA, respectively). Automated volume and maximum diameter measurements also had excellent correlation to their manual counterparts for both black blood MRI

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“…Recent studies have suggested that aortic wall biomechanical properties may be associated with AAA progression 12–15 . Aortic wall strain and distensibility, the latter being derivable from wall strain and pulse pressure, are accessible measurements reflecting these properties, and may thus be useful for risk stratification 16,17 .…”

mentioning

confidence: 99%

Measurement of Abdominal Aortic Aneurysm Strain Using MR Deformable Image Registration

Dong,

Leach,

Kao

et al. 2023

Invest Radiol

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Background Management of asymptomatic abdominal aortic aneurysm (AAA) based on maximum aneurysm diameter and growth rate fails to preempt many ruptures. Assessment of aortic wall biomechanical properties may improve assessment of progression and rupture risk. This study aimed to assess the accuracy of AAA wall strain measured by cine magnetic resonance imaging (MRI) deformable image registration (MR strain) and investigate its relationship with recent AAA progression. Methods The MR strain accuracy was evaluated in silico against ground truth strain in 54 synthetic MRIs generated from a finite element model simulation of an AAA patient's abdomen for different aortic pulse pressures, tissue motions, signal intensity variations, and image noise. Evaluation included bias with 95% confidence interval (CI) and correlation analysis. Association of MR strain with AAA growth rate was assessed in 25 consecutive patients with >6 months of prior surveillance, for whom cine balanced steady-state free-precession imaging was acquired at the level of the AAA as well as the proximal, normal-caliber aorta. Univariate and multivariate regressions were used to associate growth rate with clinical variables, maximum AAA diameter (Dmax), and peak circumferential MR strain through the cardiac cycle. The MR strain interoperator variability was assessed using bias with 95% CI, intraclass correlation coefficient, and coefficient of variation. Results In silico experiments revealed an MR strain bias of 0.48% ± 0.42% and a slope of correlation to ground truth strain of 0.963. In vivo, AAA MR strain (1.2% ± 0.6%) was highly reproducible (bias ± 95% CI, 0.03% ± 0.31%; intraclass correlation coefficient, 97.8%; coefficient of variation, 7.14%) and was lower than in the nonaneurysmal aorta (2.4% ± 1.7%). Dmax (β = 0.087) and MR strain (β= −1.563) were both associated with AAA growth rate. The MR strain remained an independent factor associated with growth rate (β= −0.904) after controlling for Dmax. Conclusions Deformable image registration analysis can accurately measure the circumferential strain of the AAA wall from standard cine MRI and may offer patient-specific insight regarding AAA progression.

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Expanding the Radiologist’s Arsenal against Abdominal Aortic Aneurysms, a Versatile Adversary

Cited by 4 publications

References 11 publications

A systematic review of anatomic predictors of abdominal aortic aneurysm remodeling after endovascular repair

A systematic review of anatomic predictors of abdominal aortic aneurysm remodeling after endovascular repair

Computer-aided quantification of non-contrast 3D black blood MRI as an efficient alternative to reference standard manual CT angiography measurements of abdominal aortic aneurysms

Measurement of Abdominal Aortic Aneurysm Strain Using MR Deformable Image Registration

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