Combining Volumetric and Wall Shear Stress Analysis from CT to Assess Risk of Abdominal Aortic Aneurysm Progression
| Autor: | Bertrand Saint-Lebes, Olivier Meyrignac, Jean Darcourt, Jean-Michel Bartoli, Marine Gaudry, Laurence Bal, Philippe Piquet, Ramiro Moreno, Agnès Sommet, A. Sewonu, Mariangela De Masi, Charline Zadro, Adrien Vavasseur, Alexis Jacquier, P Revel-Mouroz, Hervé Rousseau, Anne Nègre-Salvayre |
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| Přispěvatelé: | Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Département de Radiologie [Hôpital de la Timone - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE) |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Aorta
Receiver operating characteristic business.industry [SDV]Life Sciences [q-bio] Lumen (anatomy) medicine.disease Abdominal aortic aneurysm 030218 nuclear medicine & medical imaging 03 medical and health sciences Aortic aneurysm 0302 clinical medicine Aneurysm 030220 oncology & carcinogenesis medicine.artery cardiovascular system medicine Radiology Nuclear Medicine and imaging Derivation Nuclear medicine business Prospective cohort study ComputingMilieux_MISCELLANEOUS |
| Zdroj: | Radiology Radiology, 2020, 295 (3), pp.722-729. ⟨10.1148/radiol.2020192112⟩ |
| ISSN: | 0033-8419 1527-1315 |
| DOI: | 10.1148/radiol.2020192112⟩ |
| Popis: | Background Despite known limitations, the decision to operate on abdominal aortic aneurysm (AAA) is primarily on the basis of measurement of maximal aneurysm diameter. Purpose To identify volumetric and computational fluid dynamics parameters to predict AAAs that are likely to progress in size. Materials and Methods This study, part of a multicenter prospective registry (NCT01599533), included 126 patients with AAA. Patients were sorted into stable (≤10-mL increase in aneurysm volume) and progression (>10-mL increase in aneurysm volume) groups. Initial AAA characteristics of the derivation cohort were analyzed (maximal diameter and surface, thrombus and lumen volumes, maximal wall pressure, and wall shear stress [WSS]) to identify relevant parameters for a logistic regression model. Model and maximal diameter diagnostic performances were assessed in both cohorts and for AAAs smaller than 50 mm by using area under the receiver operating characteristic curve (AUC). Results Eighty-one patients were included (mean age, 73 years ± 7 years [standard deviation]; 78 men). The derivation and validation cohorts included, respectively, 50 and 31 participants. In the derivation cohort, there was higher mean lumen volume and lower mean WSS in the progression group compared with the stable group (60 mL ± 14 vs 46 mL ± 18 [P = .005] and 66% ± 6 vs 53% ± 9 [P = .02], respectively). Mean lumen volume and mean WSS at baseline were correlated to total volume growth (r = 0.47 [P = .002] and -0.42 [P = .006], respectively). In the derivation cohort, a regression model including lumen volume and WSS to predict aneurysm enlargement was superior to maximal diameter alone (AUC, 0.78 vs 0.52, respectively; P = .003); although no difference was found in the validation cohort (AUC, 0.79 vs 0.71, respectively; P = .51). For AAAs smaller than 50 mm, a regression model that included both baseline WSS and lumen volume performed better than maximal diameter (AUC, 0.79 vs 0.53, respectively; P = .01). Conclusion Combined analysis of lumen volume and wall shear stress was associated with enlargement of abdominal aortic aneurysms at 1 year, particularly in aneurysms smaller than 50 mm in diameter. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Mitsouras and Leach in this issue. |
| Databáze: | OpenAIRE |
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