title: Preliminary findings in quantification of changes in septal motion during follow-up of type B aortic dissections.
abstract: OBJECTIVE
  To quantify longitudinal changes in intra-arterial septum (IS) motion with two-dimensional (2D) phase-contrast magnetic resonance imaging (2D pcMRI) in type B aortic dissections (AD) to improve the understanding of AD and its midterm development.
  
  
  METHODS
  From a database of 42 patients who underwent a dynamic magnetic resonance imaging (MRI) examination at the Acute Aortic Treatment Center of The Methodist DeBakey Heart & Vascular Center, 2D pcMRI image data was available from 10 patients with type B AD for both short-term (mean, 6.6 days; range, 1-10 days; n = 7) and midterm follow-up (mean, 155 days; range, 60-324; n = 5). IS motion was quantified as motion of IS boundary points averaged over the cardiac cycle. Relative change in IS motion was expressed as percent change compared with initial presentation. Maximum IS extension (true lumen [TL] expansion) and contraction (TL compression), IS fraction in phase with aortic flow and correlation of IS motion with aortic flow (IS compliance) were quantified.
  
  
  RESULTS
  IS motion at initial presentation was 0.68 ± 0.2 mm and was reduced at short-term (0.48 ± 0.3 mm; P = .07) and midterm (0.5 ± 0.2 mm; P = .1) follow-up. Trend in relative change of IS motion was variable during short-term follow-up: reduced in three subjects (-75% ± 6%) and elevated in four subjects (48% ± 23%). During midterm follow-up, relative change in IS motion was reduced in four subjects (28% ± 19%) and slightly elevated in one (6.2%). IS contraction decreased with follow-up while IS extension slightly increased. Fraction of IS moving in phase with aortic flow increased but IS compliance decreased, suggesting increasing IS stiffness.
  
  
  CONCLUSIONS
  Reduction of IS motion in AD is seen with short-term and midterm follow-up. Intersubject variability of this trend is high at short-term follow-up but low at midterm follow-up. Detailed analysis of IS motion parameters indicate reduction of IS contraction and IS compliance with time. This has potential implications for endovascular management of type B aortic dissections, as expansion of aortic stent grafts can be limited by a stiff IS.
authors.affiliation: Methodist Hospital, Methodist DeBakey Heart & Vascular Center, Houston, TX, USA. ckarmonik@tmhs.org
authors.forename: Christof
authors.initials: C
authors.lastname: Karmonik
authors.forename: Cassidy
authors.initials: C
authors.lastname: Duran
authors.forename: Dipan J
authors.initials: DJ
authors.lastname: Shah
authors.forename: Javier E
authors.initials: JE
authors.lastname: Anaya-Ayala
authors.forename: Mark G
authors.initials: MG
authors.lastname: Davies
authors.forename: Alan B
authors.initials: AB
authors.lastname: Lumsden
authors.forename: Jean
authors.initials: J
authors.lastname: Bismuth
mesh_terms: D000784:Aortic Dissection / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D001011:Aorta / Q000503:physiopathology*; D001014:Aortic Aneurysm / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D001696:Biomechanical Phenomena; D004548:Elasticity; D006801:Humans; D008279:Magnetic Resonance Imaging; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013781:Texas; D013997:Time Factors; D016896:Treatment Outcome