Through-Plane Movement at Multiple Aortic Levels on Dynamic Computed Tomography Angiography Is Limited in Patients With an Abdominal Aortic Aneurysm.
OBJECTIVE
To analyze the movement of the aorta in the craniocaudal direction (through-plane movement) during the cardiac cycle at several levels to determine any potential impact on endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm (AAA).


METHODS
For this study, 30 patients (median age 73.0 years; 27 men) with an infrarenal AAA were randomly selected from a prospectively maintained EVAR database. All patients had undergone preoperative electrocardiogram-gated computed tomography angiography consisting of 8 phases. After semiautomatic segmentation, a 3-dimensional location probe was placed in the center of the aorta (center point) on the orthogonal slices at 12 different levels along the aorta and iliac arteries for all 8 phases. Movement of the center point during the cardiac cycle was analyzed for each level. Values are given as the median and interquartile range (IQR).


RESULTS
The median through-plane movement of all levels was 3.0 mm (IQR 2.8-3.2) and appeared to be lower in the region of the celiac and renal arteries: 2.6 mm (IQR 1.7-3.1) at 3 cm proximal to the most distal renal artery and 2.4 mm (IQR 1.9-2.9) at 1 cm distal to the most distal renal artery, respectively. The thoracic part of the aorta showed the largest through-plane motion: 4.1 mm (IQR 2.7-4.6).


CONCLUSIONS
This study quantifies aortic through-plane motion in the craniocaudal direction. Since through-plane movement appears to be limited, findings of previous studies investigating pulsatile in-plane distension seem to be representative for aortic distension.
Department of Vascular Surgery, University Medical Center Utrecht, The Netherlands.
Jeroen C
JC
de Jonge
Department of Vascular Surgery, University Medical Center Utrecht, The Netherlands.
Herman J A
HJ
Zandvoort
Department of Radiology, University Medical Center Utrecht, The Netherlands.
Evert-Jan P A
EJ
Vonken
Department of Vascular Surgery, University Medical Center Utrecht, The Netherlands.
Frans L
FL
Moll
Department of Vascular Surgery, University Medical Center Utrecht, The Netherlands j.a.vanherwaarden@umcutrecht.nl.
Joost A
JA
van Herwaarden
D000368:Aged; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging*; D001027:Aortography / Q000379:methods*; D001331:Automation; D055424:Cardiac-Gated Imaging Techniques; D003287:Contrast Media; D016208:Databases, Factual; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide
abdominal aorta; computed tomography angiography; craniocaudal movement; dynamics; endovascular aneurysm repair; out-of-plane movement; through-plane movement