Ultrasound Transducer Pressure: An Unexplored Source of Abdominal Aortic Aneurysm Measurement Error

Ghulam, Qasam; Svendsen, Morten Bo Søndergaard; Zielinski, Alexander Hakon; Eiberg, Jonas

doi:10.1016/j.ultrasmedbio.2022.05.003

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…Common ultrasound challenges such as adipose tissue, patient breathing, and bowel movements may additionally have an impact. Strain measurement can theoretically be further hampered by operatorrelated issues such as insonation angle, cross-section deviations, transducer rotation, and even transducer pressure (38)(39)(40). Unlike in diameter measurement, patient factors such as heart rate and blood pressure may also limit strain measurements.…”

Section: Discussionmentioning

confidence: 99%

Strain patterns with ultrasound for improved assessment of abdominal aortic aneurysm vessel wall biomechanics

Lorenzen,

Bracco,

Zielinski

et al. 2024

Preprint

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Background Abdominal aortic aneurysms (AAAs) are an important cause of death. Small AAAs are surveyed with ultrasound (US) until a defined diameter threshold, often triggering a CT scan and surgical repair. Nevertheless, 5-10 % of AAA ruptures are below threshold, and some large AAAs never rupture. AAA wall biomechanics may reveal vessel wall degradation with potential for patient-centred risk assessment. This clinical study investigated AAA vessel wall biomechanics and deformation patterns, including reproducibility. Methods In 50 patients with AAA, 183 video clips were recorded by two sonographers. Prototype software extracted AAA vessel wall principal strain characteristics and patterns. Functional principal component analysis (FPCA) derived strain pattern statistics. Results Strain patterns demonstrated reduced AAA wall strains close to the spine. The strain pattern 'topography' (i.e., curve phases or 'peaks' and 'valleys') had a 3.9 times lower variance than simple numeric assessment of strain amplitudes, which allowed for clustering in two groups with FPCA. A high mean reproducibility of these clusters of 87.6 % was found. Median pulse pressure-corrected mean principal strain (PPPS) was 0.038 %/mmHg (interquartile range: 0.029 to 0.051 %/mmHg) with no correlation to AAA size (Spearman's ρ = 0.02, FDR-P = 0.15). Inter-operator reproducibility of PPPS was poor (limits of agreement: +/-0.031 %/mmHg). Discussion Strain patterns challenge previous numeric stiffness measures based on AP-diameter and are reproducible for clustering. This study's PPPS aligned with prior findings, although clinical reproducibility was poor. In contrast, US-based strain patterns hold promising potential to enhance AAA risk assessment beyond traditional diameter-based metrics.

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Section: Discussionmentioning

confidence: 99%

Strain patterns with ultrasound for improved assessment of abdominal aortic aneurysm vessel wall biomechanics

Lorenzen,

Bracco,

Zielinski

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…CT images of the thoracoabdominal anatomy of 85 and 78-year-old patients affected by AAA were used to create the 3D models. The datasets were provided by Rigshospitalet (Copenhagen, DK), which recruited patients from the Copenhagen Aneurysms Cohort (COACH), a cohort of patients with AAAs under surveillance with advanced ultrasound imaging and biochemistry ( 5 ).…”

Section: Methodsmentioning

confidence: 99%

“…An abdominal aortic aneurysm (AAA) is a vascular disease that occurs when the arterial lumen dilates permanently and irreversibly, and the aortic diameter exceeds 30 mm ( 1 ). Currently, there are flaws in fully understanding the mechanisms of AAA initiation, development, and rupture, as well as in managing the treatment ( 2 – 5 ). In the biomedical field, extensive research has been performed throughout the last two decades to have insight into the AAA disease by exploiting both in-silico and in-vitro approaches as an effective alternative to animal experiments ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Fabrication of deformable patient-specific AAA models by material casting techniques

Antonuccio,

Gasparotti,

Bardi

et al. 2023

Front. Cardiovasc. Med.

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BackgroundAbdominal Aortic Aneurysm (AAA) is a balloon-like dilatation that can be life-threatening if not treated. Fabricating patient-specific AAA models can be beneficial for in-vitro investigations of hemodynamics, as well as for pre-surgical planning and training, testing the effectiveness of different interventions, or developing new surgical procedures. The current direct additive manufacturing techniques cannot simultaneously ensure the flexibility and transparency of models required by some applications. Therefore, casting techniques are presented to overcome these limitations and make the manufactured models suitable for in-vitro hemodynamic investigations, such as particle image velocimetry (PIV) measurements or medical imaging.MethodsTwo complex patient-specific AAA geometries were considered, and the related 3D models were fabricated through material casting. In particular, two casting approaches, i.e. lost molds and lost core casting, were investigated and tested to manufacture the deformable AAA models. The manufactured models were acquired by magnetic resonance, computed tomography (CT), ultrasound imaging, and PIV. In particular, CT scans were segmented to generate a volumetric reconstruction for each manufactured model that was compared to a reference model to assess the accuracy of the manufacturing process.ResultsBoth lost molds and lost core casting techniques were successful in the manufacturing of the models. The lost molds casting allowed a high-level surface finish in the final 3D model. In this first case, the average signed distance between the manufactured model and the reference was (−0.2±0.2) mm. However, this approach was more expensive and time-consuming. On the other hand, the lost core casting was more affordable and allowed the reuse of the external molds to fabricate multiple copies of the same AAA model. In this second case, the average signed distance between the manufactured model and the reference was (0.1±0.6) mm. However, the final model’s surface finish quality was poorer compared to the model obtained by lost molds casting as the sealing of the outer molds was not as firm as the other casting technique.ConclusionsBoth lost molds and lost core casting techniques can be used for manufacturing patient-specific deformable AAA models suitable for hemodynamic investigations, including medical imaging and PIV.

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Strain Patterns With Ultrasound for Assessment of Abdominal Aortic Aneurysm Vessel Wall Biomechanics

Lorenzen,

Bracco,

Zielinski

et al. 2025

Ultrasound in Medicine & Biology

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Ultrasound Transducer Pressure: An Unexplored Source of Abdominal Aortic Aneurysm Measurement Error

Cited by 3 publications

References 13 publications

Strain patterns with ultrasound for improved assessment of abdominal aortic aneurysm vessel wall biomechanics

Strain patterns with ultrasound for improved assessment of abdominal aortic aneurysm vessel wall biomechanics

Fabrication of deformable patient-specific AAA models by material casting techniques

Strain Patterns With Ultrasound for Assessment of Abdominal Aortic Aneurysm Vessel Wall Biomechanics

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