title: Regional Mapping of Aortic Wall Stress by Using Deformable, Motion-coherent Modeling based on Electrocardiography-gated Multidetector CT Angiography: Feasibility Study.
abstract: Purpose To investigate the feasibility of deformable, motion-coherent modeling based on electrocardiography-gated multidetector computed tomographic (CT) angiography of the thoracic aorta and to evaluate whether quantifiable information on aortic wall stress as a function of patient-specific cardiovascular parameters can be gained. Materials and Methods For this institutional review board-approved, HIPAA-compliant study, thoracic electrocardiography-gated dual-source multidetector CT angiographic images were used from 250 prospectively enrolled patients (150 men, 100 women; mean age, 79 years). On reconstructed 50-phase CT angiographic images, aortic strain and deformation were determined at seven cardiac and aortic locations. One-way analysis of variance was used by assessing the magnitude for longitudinal and axial strain and axial deformation, as well as time-resolved peak and maxima count for longitudinal strain and axial deformation. Interdependencies between aortic strain and deformation with extracted hemodynamic parameters were evaluated. Results With increasing heart rates, there was a significant decrease in longitudinal strain (P = .009, R(2) = 0.95) and a decrease in the number of longitudinal strain peaks (P < .001, R(2) = 0.79); however, a significant increase in axial deformation (P < .001, R(2) = 0.31) and axial strain (P = .009, R(2) = 0.61) was observed. Increasing aortic blood velocity led to increased longitudinal strain (P = .018, R(2) = 0.42) and longitudinal strain peak counts (P = .011, R(2) = 0.48). Pronounced motion in the longitudinal direction limited motion in the axial plane (P < .019, R(2) = 0.29-0.31). Conclusion The results of this study render a clinical basis and provide proof of principle for the use of deformable, motion-coherent modeling to provide quantitative information on physiological motion of the aorta under various hemodynamic circumstances. (©) RSNA, 2016 Online supplemental material is available for this article.
authors.affiliation: From the Department of Radiology, Duke University Medical Center, Durham, NC (A.M., R.A.M., L.M.H., D.M., D.T.B.); and Department of Radiology, University Hospital of Basel, 4048 Basel, Switzerland (T.J.H., D.T.B.).
authors.forename: Achille
authors.initials: A
authors.lastname: Mileto
authors.affiliation: From the Department of Radiology, Duke University Medical Center, Durham, NC (A.M., R.A.M., L.M.H., D.M., D.T.B.); and Department of Radiology, University Hospital of Basel, 4048 Basel, Switzerland (T.J.H., D.T.B.).
authors.forename: Tobias J
authors.initials: TJ
authors.lastname: Heye
authors.affiliation: From the Department of Radiology, Duke University Medical Center, Durham, NC (A.M., R.A.M., L.M.H., D.M., D.T.B.); and Department of Radiology, University Hospital of Basel, 4048 Basel, Switzerland (T.J.H., D.T.B.).
authors.forename: Ryan A
authors.initials: RA
authors.lastname: Makar
authors.affiliation: From the Department of Radiology, Duke University Medical Center, Durham, NC (A.M., R.A.M., L.M.H., D.M., D.T.B.); and Department of Radiology, University Hospital of Basel, 4048 Basel, Switzerland (T.J.H., D.T.B.).
authors.forename: Lynne M
authors.initials: LM
authors.lastname: Hurwitz
authors.affiliation: From the Department of Radiology, Duke University Medical Center, Durham, NC (A.M., R.A.M., L.M.H., D.M., D.T.B.); and Department of Radiology, University Hospital of Basel, 4048 Basel, Switzerland (T.J.H., D.T.B.).
authors.forename: Daniele
authors.initials: D
authors.lastname: Marin
authors.affiliation: From the Department of Radiology, Duke University Medical Center, Durham, NC (A.M., R.A.M., L.M.H., D.M., D.T.B.); and Department of Radiology, University Hospital of Basel, 4048 Basel, Switzerland (T.J.H., D.T.B.).
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Boll
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D000072226:Computed Tomography Angiography / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D009038:Motion; D061330:Multidetector Computed Tomography / Q000379:methods*; D015203:Reproducibility of Results