Existing and Emerging Approaches to Risk Assessment in Patients with Ascending Thoracic Aortic Dilatation

Anfinogenova, Yana; Sinitsyn, V. E.; Козлов, Б. Н.; Panfilov, D. S.; Popov, Sergey V.; Vrublevsky, Alexander V.; Chernyavsky, Alexander; Берген, Т. А.; Khovrin, V. V.; Ussov, W. Yu.

doi:10.3390/jimaging8100280

Cited by 8 publications

(8 citation statements)

References 69 publications

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“…A possible history of myocarditis may explain the persistent symptoms [34]. History of COVID-19 has been linked to an increased risk of developing aortic aneurysms [35,36]. Alarmingly, aortic strain and aortic distensibility abnormalities in the presence of SARS-CoV-2 and multisystem inflammatory syndrome may occur as early as in childhood [37].…”

Section: Discussionmentioning

confidence: 99%

Community-Based View on Diagnostic Imaging at the End of COVID-19 Pandemic: Online Survey-Assisted Study

Anfinogenova,

Maksimova,

Shelkovnikova

et al. 2024

Preprint

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Background: Online survey-based observational cross-sectional study aimed at elucidating experience and attitudes of unstructured population regarding diagnostic imaging. Methods: Invitations to participate were distributed using mixed-mode design to deidentified residents aged 18 years and older. Main outcome measures included morbidity structure and incidence of diagnostic imaging administrations. Results: Respondents (n = 1069) aged 44.3 ± 14.4 years; 32.8% suffered from cardiovascular diseases (CVD); 9.5% had chronic respiratory pathology; 28.9% considered themselves healthy. Respondents with COVID-19 history (49.7%) reported higher rates of computed tomography (CT) (p &lt; .0001), magnetic resonance imaging (MRI) (p &lt; .001), and ultrasound (p &lt; .05). COVID-19 history in CVD respondents shifted imaging administrations towards CT and MRI (p &lt; .05). Every tenth respondent received MRI, CT, and ultrasound on paid basis; 29.0% could not pay for diagnostic procedures; 13.1% reported unavailable MRI. Professional status significantly affected the pattern of diagnostic modalities (p &lt; .05). MRI and CT availability differed between respondents in urban and rural areas (p &lt; .0001). History of technogenic events predisposed responders to overestimate diagnostic value of fluorography (p &lt; .05). Conclusions: Preparedness to future pandemics requires development of community-based outreach programs focusing on people's awareness regarding medical imaging safety and diagnostic value.

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Section: Discussionmentioning

confidence: 99%

Community-Based View on Diagnostic Imaging at the End of COVID-19 Pandemic: Online Survey-Assisted Study

Anfinogenova,

Maksimova,

Shelkovnikova

et al. 2024

Preprint

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“…Gadolinium-based (Gd) contrast-enhanced time-resolved magnetic resonance angiography (CE-trMRA) techniques are able to depict the anatomy and haemodynamics of complex vascular structures [1][2][3][4][5][6][7][8]. While computed tomography angiography (CTA) with its inherent ionising radiation dose remains the reference method for thoracic imaging in an acute clinical setting [1,[9][10][11][12], CE-trMRA stands as a valuable alternative to CTA avoiding ionizing radiation and providing dynamic contrast information [1-3, 5, 8].…”

Section: Introductionmentioning

confidence: 99%

Dynamic Contrast-Enhanced MRA of the aorta using a Golden-Angle Radial Sparse Parallel (GRASP) sequence: comparison with conventional time-resolved Cartesian MRA (TWIST)

Calastra,

Kleban,

Helfenstein

et al. 2024

Preprint

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Purpose: to compare the application of two contrast-enhanced time-resolved magnetic resonance angiography sequences on an aortic diseases patient cohort: the conventional Cartesian-sampling-based, TWIST sequence, and the radial-sampling-based GRASP sequence. Radial-sampling-based techniques are less sensitive to motion than cartesian sampling and consequently are expected to improve the image quality in body parts subjected to motion. Methods: 1.5T magnetic resonance angiography data from thirty patients (60.9±16.1y.o.) were assessed to investigate image quality as well as spatial and temporal blurring in the ascending aorta (AA), descending aorta (DA) and abdominal aorta (AbA). Results: GRASP offered superior depiction of vascular structures in terms of vascular contrast for qualitative analysis (TWIST, reader 1: 1.6±0.5; reader 2: 1.9±0.4; reader 3: 1.1±0.4; GRASP, reader 1: 1.5±0.5; reader 2: 1.4±0.5; reader 3: 1.0±0.2) and vessel sharpness for qualitative (TWIST, reader 1: 1.9±0.6; reader 2: 1.6±0.6; reader 3: 2.0±0.3; GRASP, reader 1: 1.4±0.6; reader 2: 1.2±0.4; reader 3: 1.3±0.6) and quantitative analysis (TWIST, AA=0.12±0.04, DA=0.12±0.03, AbA=0.11±0.03; GRASP, AA=0.20±0.05, DA=0.22±0.06, AbA=0.20±0.05). Streaking artefacts of GRASP were stronger visible compared to TWIST (TWIST, reader 1: 2.2±0.6; reader 2: 1.9±0.3; reader 3: 2.0±0.5; GRASP, reader 1: 2.6±0.6; reader 2: 2.3±0.5; reader 3: 2.8±0.6). Conclusion: GRASP outperformed TWIST in SNR, vessel sharpness and reduction in image blurring; streaking artifacts were stronger visible with GRASP, but did not affect diagnostic image quality.

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“…The estimated pooled incidence is between 5 and 10/100,000 individuals per year ( Kuzmik et al., 2012 ; Melo et al., 2021 ). To date, the main criterion for elective ascending aortic surgery of non-urgent cases is the maximum diameter assessment whose decision threshold is generally fixed at 55 mm ( Anfinogenova et al., 2022 ). Unfortunately, this does not seem to correctly reflect the AsAA patient’s risk of rupture ( Elefteriades and Farkas, 2010 ; Tozzi et al., 2021 ) and is often considered insufficient as criterion of choice ( Sonsino et al., 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Assessment of shape-based features ability to predict the ascending aortic aneurysm growth

et al. 2023

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The current guidelines for the ascending aortic aneurysm (AsAA) treatment recommend surgery mainly according to the maximum diameter assessment. This criterion has already proven to be often inefficient in identifying patients at high risk of aneurysm growth and rupture. In this study, we propose a method to compute a set of local shape features that, in addition to the maximum diameter D, are intended to improve the classification performances for the ascending aortic aneurysm growth risk assessment. Apart from D, these are the ratio DCR between D and the length of the ascending aorta centerline, the ratio EILR between the length of the external and the internal lines and the tortuosity T. 50 patients with two 3D acquisitions at least 6 months apart were segmented and the growth rate (GR) with the shape features related to the first exam computed. The correlation between them has been investigated. After, the dataset was divided into two classes according to the growth rate value. We used six different classifiers with input data exclusively from the first exam to predict the class to which each patient belonged. A first classification was performed using only D and a second with all the shape features together. The performances have been evaluated by computing accuracy, sensitivity, specificity, area under the receiver operating characteristic curve (AUROC) and positive (negative) likelihood ratio LHR+ (LHR−). A positive correlation was observed between growth rate and DCR (r = 0.511, p = 1.3e-4) and between GR and EILR (r = 0.472, p = 2.7e-4). Overall, the classifiers based on the four metrics outperformed the same ones based only on D. Among the diameter-based classifiers, k-nearest neighbours (KNN) reported the best accuracy (86%), sensitivity (55.6%), AUROC (0.74), LHR+ (7.62) and LHR− (0.48). Concerning the classifiers based on the four shape features, we obtained the best accuracy (94%), sensitivity (66.7%), specificity (100%), AUROC (0.94), LHR+ (+∞) and LHR− (0.33) with support vector machine (SVM). This demonstrates how automatic shape features detection combined with risk classification criteria could be crucial in planning the follow-up of patients with ascending aortic aneurysm and in predicting the possible dangerous progression of the disease.

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Existing and Emerging Approaches to Risk Assessment in Patients with Ascending Thoracic Aortic Dilatation

Cited by 8 publications

References 69 publications

Community-Based View on Diagnostic Imaging at the End of COVID-19 Pandemic: Online Survey-Assisted Study

Community-Based View on Diagnostic Imaging at the End of COVID-19 Pandemic: Online Survey-Assisted Study

Dynamic Contrast-Enhanced MRA of the aorta using a Golden-Angle Radial Sparse Parallel (GRASP) sequence: comparison with conventional time-resolved Cartesian MRA (TWIST)

Assessment of shape-based features ability to predict the ascending aortic aneurysm growth

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