Patient Specific Wall Stress Analysis and Mechanical Characterization of Abdominal Aortic Aneurysms Using 4D Ultrasound

Disseldorp, Emiel M.J. van; Petterson, Niels J.; Rutten, Marcel; Vosse, F.N. van de; Sambeek, Marc R.H.M. van; Lopata, R.G.P.

doi:10.1016/j.ejvs.2016.07.088

Cited by 52 publications

(50 citation statements)

References 21 publications

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“…Both proximal and distal ends were elongated to avoid the effects of the boundary conditions on the wall stresses in the aneurysm. 13 The CT based geometries were imported in the meshing software package 3-Matic 5.1 (Materialise, Leuven, Belgium) because of the complex meshing procedure around the bifurcation. Finally, the CT based meshes were created with mesh density similar to the US based mesh.…”

Section: Wall Stress Analysismentioning

confidence: 99%

“…In addition, manual segmentation of the US data was executed in the subgroup of AAA patients where no fusion was needed, since these data were similar to the 3D US data used in previous feasibility studies. 12,13 To compare the CT based geometries with the US contours, both modalities were registered using the described registration method. The agreement between the three different segmentations was quantified by the SI, a measure for agreement in geometry overlap, and the Hausdorff distance (HD), which quantifies the maximum local deviations between the two segmented geometries.…”

Section: Validationmentioning

confidence: 99%

“…Despite these challenges, geometry assessment and wall stress analysis using 3D US in selected AAAs has been shown to be feasible, 12e14 and revealed similar results when compared with CT based methods. 12,13 Therefore, 3D US could be an ideal imaging modality of perform patient specific wall stress analysis in longitudinal studies that could lead to a better understanding and prediction of aneurysm rupture risk or growth.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound Based Wall Stress Analysis of Abdominal Aortic Aneurysms using Multiperspective Imaging

Disseldorp

Dronkelaar

Pluim

et al. 2020

European Journal of Vascular and Endovascular Surgery

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WHAT THIS PAPER ADDS Fusion of multiperspective 3D ultrasound (US) imaging of abdominal aortic aneurysms (AAAs) with a large longitudinal length was developed for automatic assessment of AAA geometry and patient specific wall stress analysis using biomechanical modelling. This study showed that US based geometry and wall stress results were in good agreement with CT, enabling harmless and cost efficient longitudinal studies on wall stress and AAA growth for aneurysms of all lengths and sizes. Background: Current clinical guidelines for surgical repair of abdominal aortic aneurysms (AAAs) are primarily based on maximum diameter assessment. From a biomechanical point of view, not only the diameter but also peak wall stresses will play an important role in rupture risk assessment. These methods require patient specific geometry which typically uses computed tomography (CT) or magnetic resonance imaging. Recently, wall stress analysis based on 3D ultrasound (US) has been proposed, and shows promising results. However, the major limitations in these studies were the use of manual segmentation and the limiting field of view of US. Therefore in this study, the AAA is imaged with multiperspective 3D ultrasound, merged to obtain a large field of view, and afterwards automatically segmented. Geometry and wall stress results were validated using CT imaging. Methods: Three dimensional US and CT data were available for 40 AAA patients (maximum diameter 34e61 mm). The full US based AAA geometry was determined using automatic segmentation, and when the aneurysm exceeded a single 3D volume, automatic fusion of multiple 3D US volumes was used. Wall stress analysis was performed for all AAA patients and percentile wall stresses were derived. The accuracy of the US based geometry and wall stress prediction was measured by comparison with CT data. Results: Estimated geometries derived from 3D US and CT data showed good similarity, with an overall median similarity index (SI) of 0.89 and interquartile range of 0.87e0.92, whereas the median Hausdorff distances (HD), a measure for the maximum local mismatch, was 4.6 (4.0e5.9) mm for all AAA geometries. Thereby, the wall stress results based on merged multiperspective 3D US data revealed a greater similarity to CT than single 3D US data. Conclusion: This study showed that large volume geometry assessment of AAAs using multiperspective 3D ultrasound, segmentation and fusion, and wall stress analysis is feasible in a robust and labour efficient manner.

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Section: Wall Stress Analysismentioning

confidence: 99%

Section: Validationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ultrasound Based Wall Stress Analysis of Abdominal Aortic Aneurysms using Multiperspective Imaging

Disseldorp

Dronkelaar

Pluim

et al. 2020

European Journal of Vascular and Endovascular Surgery

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show abstract

“…Hence the large diameter criterion is found to be insufficient in predicting the risk of rupture and the necessity for surgical intervention . Biomechanical factors such as peak wall stress are found to be more reliable in predicting the risk of rupture than the size of aorta diameter . 4D phase‐encoding magnetic resonance imaging (MRI) which is used to evaluate blood flow characteristics showed that patient possessing ATAA exhibit disturbed flow pattern.…”

Section: Introductionmentioning

confidence: 99%

Computational prediction of hemodynamical and biomechanical alterations induced by aneurysm dilatation in patient‐specific ascending thoracic aortas

Jayendiran

Condemi

Campisi

et al. 2020

Numer Methods Biomed Eng

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The aim of the present work is to propose a robust computational framework combining computational fluid dynamics (CFD) and 4D flow MRI to predict the progressive changes in hemodynamics and wall rupture index (RPI) induced by aortic morphological evolutions in patients harboring ascending thoracic aortic aneurysms (ATAAs). An analytical equation has been proposed to predict the aneurysm progression based on age, sex, and body surface area. Parameters such as helicity, wall shear stress (WSS), time‐averaged WSS, oscillatory shear index, relative residence time, and viscosity were evaluated for two patients at different stages of aneurysm growth, and compared with age‐sex‐matched healthy subjects. The study shows that evolution of hemodynamics and RPI, despite being very slow in ATAAs, is strongly affected by morphological alterations and, in turn could impact biomechanical factors and aortic mechanobiology. An aspect of the current work is that the patient‐specific 4D MRI data sets were obtained with a follow‐up of 1 year and the measured time‐averaged velocity maps and flow eccentricity were compared with the CFD simulation for validation. The computational framework presented here is capable of capturing the blood flow patterns and the hemodynamic descriptors during the various stages of aneurysm growth. Further investigations will be conducted in order to verify these results on a larger cohort of patients and with long follow‐up times to finally elucidate the link between deranged hemodynamics, AA geometry, and wall mechanical properties in ATAAs.

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“…Recent works have shown that, based on invivo data provided by medical images, these techniques can be used to estimate the in-vivo stress state of arterial segments in the presence of preloads [23,24,25], the unloaded configuration corresponding to those segments [8,26,27,28,29], or the material parameters characterizing the mechanical behavior of the soft tissues 1 Recoverable in the sense that the energy stored in the material can be fully recovered when kinematic restrictions are released, for example, through excision of the tissue. [30,31,32,33,34,35,36]. Remarkably, the predicted values for those material parameters are heavily influenced by the hypotheses considered to introduce the effect of residual stresses [37].…”

Section: Introductionmentioning

confidence: 99%

Identification of residual stresses in multi-layered arterial wall tissues using a variational framework

Ares

Blanco

Urquiza

et al. 2017

Computer Methods in Applied Mechanics and Engineering

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Patient Specific Wall Stress Analysis and Mechanical Characterization of Abdominal Aortic Aneurysms Using 4D Ultrasound

Cited by 52 publications

References 21 publications

Ultrasound Based Wall Stress Analysis of Abdominal Aortic Aneurysms using Multiperspective Imaging

Ultrasound Based Wall Stress Analysis of Abdominal Aortic Aneurysms using Multiperspective Imaging

Computational prediction of hemodynamical and biomechanical alterations induced by aneurysm dilatation in patient‐specific ascending thoracic aortas

Identification of residual stresses in multi-layered arterial wall tissues using a variational framework

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