Section of Vascular Surgery, Department of Surgery, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA.
Department of Radiology, University of Michigan, Ann Arbor, MI, USA.
Sci Rep. 2024 Oct 16;14(1):24215. doi: 10.1038/s41598-024-75334-z.
Although abdominal aortic aneurysms (AAA) are more common in men, women are at greater risk for AAA growth/rupture. Vascular deformation mapping (VDM) utilizes deformable image registration to qualify and quantify 3D-AAA growth using computed tomography angiograms (CTA). In this study we leveraged VDM to investigate sex differences in AAA growth patterns. Patients with infra-renal AAA and ≥ 2 CTA were identified. Males and females were matched for age, hypertension, and smoking history. Patient characteristics, maximum diameter (Dmax), and AAA volume were obtained. CTA images were segmented, and VDM was conducted to quantify 3D AAA growth rate per year (GR, cm/year). Statistical shape modeling was utilized to compute mean aneurysm shapes and 3D GR. Average GR was evaluated at specific regions of the aortic surface for males and females. Seventeen males and 17 females were matched. At the individual level, there were no sex differences in changes in Dmax or AAA volume. However, females had larger GR across the anterior and right lateral AAA (1.33 vs 0.89 and 1.56 vs 0.74 cm/year, respectively), despite no difference in posterior or left lateral AAA GR. Despite comparable changes in Dmax, AAA volume, and GR magnitude, women demonstrated a more eccentric, anterior-predominant, AAA growth pattern.
尽管腹主动脉瘤（AAA）在男性中更为常见，但女性发生 AAA 生长/破裂的风险更高。血管变形测绘（VDM）利用可变形图像配准，利用 CT 血管造影（CTA）对 3D-AAA 生长进行定性和定量。在这项研究中，我们利用 VDM 研究 AAA 生长模式的性别差异。确定了肾下 AAA 且至少有 2 次 CTA 的患者。对男性和女性进行了年龄、高血压和吸烟史匹配。获取患者特征、最大直径（Dmax）和 AAA 体积。对 CTA 图像进行分割，并进行 VDM 以量化每年的 3D AAA 增长率（GR，cm/年）。利用统计形状建模计算平均动脉瘤形状和 3D GR。评估了男性和女性主动脉表面特定区域的平均 GR。匹配了 17 名男性和 17 名女性。在个体水平上，Dmax 或 AAA 体积的变化在男性和女性之间没有差异。然而，尽管在后侧或左侧 AAA 的 GR 没有差异，但女性在前侧和右侧 AAA 的 GR 更大（分别为 1.33 比 0.89 和 1.56 比 0.74 cm/年）。尽管 Dmax、AAA 体积和 GR 幅度的变化相当，但女性表现出更偏心、前位为主的 AAA 生长模式。
