Changes in Aortic Diameter and Wall Strain in Progressing Abdominal Aortic Aneurysms.
abdominal aortic aneurysm
follow-up
heterogeneity
wall strain
Journal
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
ISSN: 1550-9613
Titre abrégé: J Ultrasound Med
Pays: England
ID NLM: 8211547
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
revised:
15
01
2023
received:
29
10
2022
accepted:
29
01
2023
medline:
21
7
2023
pubmed:
17
2
2023
entrez:
16
2
2023
Statut:
ppublish
Résumé
The analysis of wall strain opens new perspectives in the prediction of abdominal aortic aneurysm (AAA) rupture. This study investigates the capability of four-dimensional ultrasound (4D US) to detect and characterize changes in wall strain in the same patients during follow-up observations. Eighteen patients were examined by 64 4D US scans during a median follow-up period of 24.5 months. After performing the 4D US and manual aneurysm segmentation, kinematic analysis was performed using a customized interface and evaluation of the mean and peak circumferential strain, as well as spatial heterogeneity. All aneurysms showed a continuous diameter growth with a mean rate of 4% per year (P < .001). The mean circumferential strain (MCS) tends to increase from a median 0.89% by 10.49% per year in follow-up independent of the aneurysm diameter (P = .063). The subgroup analysis reveals a cohort with increasing MCS and decreasing spatial heterogeneity, as well as a cohort with nonincreasing MCS and increasing spatial heterogeneity (P < .05). The 4D US is able to register the strain changes in AAA follow-up. The MCS tends to increase during the observation time in the entire cohort, but the changes were independent of the maximum aneurysm diameter. The kinematic parameters allow the entire AAA cohort to differentiate into two subgroups and provide additional information about the pathologic behavior of the aneurysm wall.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1737-1746Subventions
Organisme : Adolf Messer Foundation
Organisme : Ministry of Higher Education, Research and the Arts (HMWK, Hesse, Germany)
Informations de copyright
© 2023 The Authors. Journal of Ultrasound in Medicine published by Wiley Periodicals LLC on behalf of American Institute of Ultrasound in Medicine.
Références
Schmitz-Rixen T, Steffen M, Böckler D, Grundmann RT. Treatment of abdominal aortic aneurysms (AAA) 2018: registry report from the German Institute of Vascular Healthcare Research (DIGG) of the German Society for Vascular Surgery and Vascular Medicine (DGG). Gefässchirurgie 2020; 25:117-123. https://doi.org/10.1007/s00772-020-00619-2.
Wanhainen A, Verzini F, Van Herzeele I, et al. Editor's choice-European Society for Vascular Surgery (ESVS) 2019 clinical practice guidelines on the management of abdominal aorto-iliac artery aneurysms. Eur J Vasc Endovasc Surg 2019; 57:8-93. https://doi.org/10.1016/j.ejvs.2018.09.020.
Derwich W, Wittek A, Pfister K, et al. High resolution strain analysis comparing aorta and abdominal aortic aneurysm with real time three dimensional speckle tracking ultrasound. Eur J Vasc Endovasc Surg 2016; 51:187-193. https://doi.org/10.1016/j.ejvs.2015.07.042.
Derwich W, Wittek A, Hegner A, Fritzen CP, Blase C, Schmitz-Rixen T. Comparison of abdominal aortic aneurysm sac and neck wall motion with 4D ultrasound imaging. Eur J Vasc Endovasc Surg 2020; 60:539-547. https://doi.org/10.1016/j.ejvs.2020.06.027.
Karatolios K, Wittek A, Nwe TH, et al. Method for aortic wall strain measurement with three-dimensional ultrasound speckle tracking and fitted finite element analysis. Ann Thorac Surg 2013; 96:1664-1671. https://doi.org/10.1016/j.athoracsur.2013.06.037.
Wittek A, Derwich W, Fritzen CPCP, Schmitz-Rixen T, Blase C. Towards non-invasive in vivo characterization of the pathophysiological state and mechanical wall strength of the individual human AAA wall based on 4D ultrasound measurements. Z Angew Math Mech 2018; 98:2275-2294. https://doi.org/10.1002/zamm.201700353.
Thompson SG, Brown LC, Sweeting MJ, et al. Systematic review and meta-analysis of the growth and rupture rates of small abdominal aortic aneurysms: implications for surveillance intervals and their cost-effectiveness. Health Technol Assess 2013; 17:1-118. https://doi.org/10.3310/hta17410.
Sweeting MJ, Thompson SG, Brown LC, Powell JT. Meta-analysis of individual patient data to examine factors affecting growth and rupture of small abdominal aortic aneurysms. Br J Surg 2012; 99:655-665. https://doi.org/10.1002/BJS.8707.
Li T, Liu X, Sun H, Ning H, Yang J, Ma C. Assessment of the global and regional circumferential strain of abdominal aortic aneurysm with different size by speckle-tracking echocardiography. J Ultrasound Med 2021; 40:2619-2627. https://doi.org/10.1002/JUM.15651.
Hoegh A, Lindholt JS. Basic science review. Vascular distensibility as a predictive tool in the management of small asymptomatic abdominal aortic aneurysms. Vasc Endovasc Surg 2009; 43:333-338. https://doi.org/10.1177/1538574409336019.
Wilson KA, Lee AJ, Hoskins PR, Fowkes FGR, Ruckley CV, Bradbury AW. The relationship between aortic wall distensibility and rupture of infrarenal abdominal aortic aneurysm. J Vasc Surg 2003; 37:112-117. https://doi.org/10.1067/mva.2003.40.
Niestrawska JA, Regitnig P, Viertler C, Cohnert TU, Babu AR, Holzapfel GA. The role of tissue remodeling in mechanics and pathogenesis of abdominal aortic aneurysms. Acta Biomater 2019; 88:149-161. https://doi.org/10.1016/J.ACTBIO.2019.01.070.