Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI 48109, USA.
Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI 48109, USA.
Tomography. 2021 May 13;7(2):189-201. doi: 10.3390/tomography7020017.
Abdominal aortic aneurysm (AAA) is a complex disease that requires regular imaging surveillance to monitor for aneurysm stability. Current imaging surveillance techniques use maximum diameter, often assessed by computed tomography angiography (CTA), to assess risk of rupture and determine candidacy for operative repair. However, maximum diameter measurements can be variable, do not reliably predict rupture risk and future AAA growth, and may be an oversimplification of complex AAA anatomy. Vascular deformation mapping (VDM) is a recently described technique that uses deformable image registration to quantify three-dimensional changes in aortic wall geometry, which has been previously used to quantify three-dimensional (3D) growth in thoracic aortic aneurysms, but the feasibility of the VDM technique for measuring 3D growth in AAA has not yet been studied. Seven patients with infra-renal AAAs were identified and VDM was used to identify three-dimensional maps of AAA growth. In the present study, we demonstrate that VDM is able to successfully identify and quantify 3D growth (and the lack thereof) in AAAs that is not apparent from maximum diameter. Furthermore, VDM can be used to quantify growth of the excluded aneurysm sac after endovascular aneurysm repair (EVAR). VDM may be a useful adjunct for surgical planning and appears to be a sensitive modality for detecting regional growth of AAAs.
腹主动脉瘤（AAA）是一种复杂的疾病，需要定期进行影像学监测，以监测动脉瘤的稳定性。目前的影像学监测技术使用最大直径（通常通过计算机断层血管造影术（CTA）评估）来评估破裂风险并确定手术修复的适应证。然而，最大直径测量值可能存在差异，无法可靠预测破裂风险和未来 AAA 的生长情况，并且可能是对复杂 AAA 解剖结构的过度简化。血管变形映射（VDM）是一种最近描述的技术，它使用可变形图像配准来量化主动脉壁几何形状的三维变化，该技术以前曾用于量化胸主动脉瘤的三维（3D）生长，但 VDM 技术测量 AAA 的 3D 生长的可行性尚未得到研究。本研究中，我们确定了 7 例肾下 AAA 患者，并使用 VDM 识别 AAA 生长的三维图谱。在本研究中，我们证明 VDM 能够成功识别和量化从最大直径上无法明显看出的 AAA 的 3D 生长（和缺乏生长）。此外，VDM 可用于量化血管内动脉瘤修复（EVAR）后排除的瘤囊的生长。VDM 可能是手术计划的有用辅助手段，并且似乎是检测 AAA 区域性生长的敏感方式。
