4D ultrasound strain imaging revealed significantly reduced in-plane strain and increased circumferential strain heterogeneity in AAA patients compared to young and aged non-AAA controls.
Observational
Does 4D ultrasound strain imaging differentiate the mechanical behavior of the aortic wall in AAA patients compared to healthy volunteers and aged arteriosclerotic patients?
4D ultrasound strain imaging can differentiate the mechanical properties of the aortic wall in AAA patients from those without AAA, offering a potential novel biomarker for assessing rupture risk.
Abdominal aortic aneurysms (AAA) are a degenerative disease of the human aortic wall that may lead to weakening and eventually rupture of the wall with high mortality rates. Since the currently established criterion for surgical or endovascular treatment of the disease is imprecise in the individual case and treatment is not free of complications, the need for additional patient-individual biomarkers for short-term AAA rupture risk as basis for improved clinical decision making. Time resolved 3D ultrasound combined with speckle tracking algorithms is a novel non-invasive medical imaging technique that provides full-field displacement and strain measurements of aortic and aneurysmal wall motion. This is patient-individual information that has not been used so far to assess wall strength and rupture risk. The current study uses simple statistical indices of the heterogeneous spatial distribution of in-plane strain components as biomarkers for the pathological state of the aortic and aneurysmal wall. The pathophysiological rationale behind this approach are the known changes in microstructural composition of the aortic wall with progression of AAA development that results in increased stiffening and heterogeneity of the walls mechanical properties and in decreased wall strength. In a comparative analysis of the aortic wall motion of young volunteers without known cardiovascular diseases, aged arteriosclerotic patients without AAA, and AAA patients, mean values of all in-plane strain components were significantly reduced, and the heterogeneity of circumferential strain was significantly increased in the AAA group compared to both other groups. The capacity of the proposed method to differentiate between wall motion of aged, arteriosclerotic patients and AAA patients is a promising step towards a new method for in vivo assessment of AAA wall strength or stratification of AAA rupture risk as basis for improved clinical decision making on surgical or endovascular treatment of AAA.
Wittek et al. (Mon,) conducted a observational in Abdominal aortic aneurysms. 4D ultrasound strain imaging vs. Young volunteers and aged arteriosclerotic patients without AAA was evaluated on Mean values of in-plane strain components and heterogeneity of circumferential strain. 4D ultrasound strain imaging revealed significantly reduced in-plane strain and increased circumferential strain heterogeneity in AAA patients compared to young and aged non-AAA controls.