Goudot Guillaume, Cheng Charles, Guédon Alexis F, Mirault Tristan, Pedreira Olivier, Dahan Alexandre, Wang Louise Z, Pernot Mathieu, Messas Emmanuel
Physics for Medicine Paris, INSERM U1273, ESPCI Paris, CNRS FRE, PSL Research University, Paris, France.
Vascular Medicine Department, Georges-Pompidou European Hospital, AP-HP, Université Paris Cité, Paris, France.
Front Physiol. 2023 Mar 3;14:1128663. doi: 10.3389/fphys.2023.1128663. eCollection 2023.
Aortic maximal rate of systolic distention (MRSD) is a prognosis factor of ascending aorta dilatation with magnetic resonance imaging. Its calculation requires precise continuous tracking of the aortic diameter over the cardiac cycle, which is not feasible by focused ultrasound. We aimed to develop an automatic aortic acquisition using ultrafast ultrasound imaging (UUI) to provide access to the aortic MRSD. A phased array probe and developed sequences at 2000 frames/s were used. A created interface automatically tracked the anterior and posterior aortic walls over the cardiac cycle. Tissue Doppler allowed a precise estimation of the walls' movements. MRSD was the maximum derivative of the aortic diameter curve over time. To assess its feasibility, 34 patients with bicuspid aortic valve (BAV) and 31 controls were consecutively included to evaluate the BAV-associated aortopathy at the sinus of Valsalva, the tubular ascending aorta, and the aortic arch. UUI acquisitions and the dedicated interface allow tracking of the aortic diameter and calculating the MRSD for the BAV patients and controls (mean age of 34 vs. 43 years, = 0.120). A trend toward lower deformation in the different aortic segments was observed, as expected. Still, only the MRSD with UUI was significantly different at the sinus of Valsalva in this small series: (0.61 .10.s [0.37-0.72] for BAV patients vs. 0.92 .10.s [0.72-1.02] for controls, = 0.025). Aortic deformation evaluated with UUI deserves attention with a simple and automated measurement technique that could assess the segmental aortic injury associated with BAV.
主动脉收缩期最大扩张速率（MRSD）是磁共振成像评估升主动脉扩张的一个预后因素。其计算需要在心动周期中精确连续跟踪主动脉直径，而聚焦超声无法做到这一点。我们旨在开发一种使用超快超声成像（UUI）自动采集主动脉图像的方法，以获取主动脉MRSD。使用了相控阵探头和2000帧/秒的开发序列。创建的界面在心动周期中自动跟踪主动脉前后壁。组织多普勒可精确估计壁的运动。MRSD是主动脉直径曲线随时间的最大导数。为评估其可行性，连续纳入34例二叶式主动脉瓣（BAV）患者和31例对照，以评估在主动脉瓣窦、升主动脉管状部和主动脉弓处与BAV相关的主动脉病变。UUI采集和专用界面允许跟踪主动脉直径并计算BAV患者和对照的MRSD（平均年龄分别为34岁和43岁，P = 0.120）。正如预期的那样，观察到不同主动脉节段的变形有降低的趋势。不过，在这个小样本系列中，只有UUI测量的MRSD在主动脉瓣窦处有显著差异：BAV患者为0.61×10⁻³/s[0.37 - 0.72]，对照为0.92×10⁻³/s[0.72 - 1.02]，P = 0.025。用UUI评估的主动脉变形值得关注，因为它是一种简单且自动化的测量技术，可以评估与BAV相关的节段性主动脉损伤。
