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- Martufi, Giampaolo, et al.
(författare)
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Three-Dimensional Geometrical Characterization of Abdominal Aortic Aneurysms : Image-Based Wall Thickness Distribution
- 2009
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Ingår i: Journal of Biomechanical Engineering. - : ASME International. - 0148-0731 .- 1528-8951. ; 131:6, s. 061015-
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Tidskriftsartikel (refereegranskat)abstract
- The clinical assessment of abdominal aortic aneurysm (AAA) rupture risk is based on the quantification of AAA size by measuring its maximum diameter from computed tomography (CT) images and estimating the expansion rate of the aneurysm sac over time. Recent findings have shown that geometrical shape and size, as well as local wall thickness may be related to this risk; thus, reliable noninvasive image-based methods to evaluate AAA geometry have a potential to become valuable clinical tools. Utilizing existing CT data, the three-dimensional geometry of nine unruptured human AAAs was reconstructed and characterized quantitatively. We propose and evaluate a series of 1D size, 2D shape, 3D size, 3D shape, and second-order curvature-based indices to quantify AAA geometry, as well as the geometry of a size-matched idealized fusiform aneurysm and a patient-specific normal abdominal aorta used as controls. The wall thickness estimation algorithm, validated in our previous work, is tested against discrete point measurements taken from a cadaver tissue model, yielding an average relative difference in AAA wall thickness of 7.8%. It is unlikely that any one of the proposed geometrical indices alone would be a reliable index of rupture risk or a threshold for elective repair. Rather, the complete geometry and a positive correlation of a set of indices should be considered to assess the potential for rupture. With this quantitative parameter assessment, future research can be directed toward statistical analyses correlating the numerical values of these parameters with the risk of aneurysm rupture or intervention (surgical or endovascular). While this work does not provide direct insight into the possible clinical use of the geometric parameters, we believe it provides the foundation necessary for future efforts in that direction.
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| 3. |
- Riveros, Fabian, et al.
(författare)
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A Pull-Back Algorithm to Determine the Unloaded Vascular Geometry in Anisotropic Hyperelastic AAA Passive Mechanics
- 2013
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Ingår i: Annals of Biomedical Engineering. - : Springer Science and Business Media LLC. - 0090-6964 .- 1573-9686. ; 41:4, s. 694-708
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Tidskriftsartikel (refereegranskat)abstract
- Biomechanical studies on abdominal aortic aneurysms (AAA) seek to provide for better decision criteria to undergo surgical intervention for AAA repair. More accurate results can be obtained by using appropriate material models for the tissues along with accurate geometric models and more realistic boundary conditions for the lesion. However, patient-specific AAA models are generated from gated medical images in which the artery is under pressure. Therefore, identification of the AAA zero pressure geometry would allow for a more realistic estimate of the aneurysmal wall mechanics. This study proposes a novel iterative algorithm to find the zero pressure geometry of patient-specific AAA models. The methodology allows considering the anisotropic hyperelastic behavior of the aortic wall, its thickness and accounts for the presence of the intraluminal thrombus. Results on 12 patient-specific AAA geometric models indicate that the procedure is computational tractable and efficient, and preserves the global volume of the model. In addition, a comparison of the peak wall stress computed with the zero pressure and CT-based geometries during systole indicates that computations using CT-based geometric models underestimate the peak wall stress by 59 +/- A 64 and 47 +/- A 64 kPa for the isotropic and anisotropic material models of the arterial wall, respectively.
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| 4. |
- Rodriguez, Jose F., et al.
(författare)
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The Effect of Material Model Formulation in the Stress Analysis of Abdominal Aortic Aneurysms
- 2009
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Ingår i: Annals of Biomedical Engineering. - : Springer Science and Business Media LLC. - 0090-6964 .- 1573-9686. ; 37:11, s. 2218-2221
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Tidskriftsartikel (refereegranskat)abstract
- A reliable estimation of wall stress in Abdominal Aortic Aneurysms (AAAs), requires performing an accurate three-dimensional reconstruction of the medical image-based native geometry and modeling an appropriate constitutive law for the aneurysmal tissue material characterization. A recent study on the biaxial mechanical behavior of human AAA tissue specimens demonstrates that aneurysmal tissue behaves mechanically anisotropic. Results shown in this communication show that the peak wall stress is highly sensitive to the anisotropic model used for the stress analysis. In addition, the present investigation indicates that structural parameters (e.g., collagen fiber orientation) should be determined independently and not by means of non-linear fitting to stress-strain test data. Fiber orientation identified in this manner could lead to overestimated peak wall stresses.
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| 5. |
- Rodríguez, José F., et al.
(författare)
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The role of material anisotropy in abdominal aortic aneurysm wall mechanics
- 2008
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Ingår i: WCCM8.
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Konferensbidrag (refereegranskat)abstract
- The prevalence of AAA is growing along with population age and according to different studies AAA rupture is the 13th most common cause of death in the U.S., causing an estimated 15,000 deaths per year. In biomechanical terms, AAA rupture is a phenomenon that occurs when the developing mechanical stresses within the aneurysm inner wall, as a result of the exerted intraluminal pressure, exceed the failure strength of the aortic tissue. To obtain a reliable estimation of wall stress, it is necessary to perform an accurate three-dimensional reconstruction of the AAA geometry and model an appropriate constitutive law for the aneurysmal tissue material characterization. In this regard, a recent study on the biaxial mechanical behavior of human AAA tissue specimens [1] demonstrates that aneurysmal arterial tissue behaves mechanically anisotropic. The objectives of the present work are to determine the effect of material anisotropy of the aneurysmal abdominal aorta on wall stress distribution and to establish a comparison of wall mechanics between ruptured and unruptured aneurysms.
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| 9. |
- Shum, Judy, et al.
(författare)
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Quantitative Assessment of Abdominal Aortic Aneurysm Geometry
- 2011
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Ingår i: Annals of Biomedical Engineering. - : Springer Science and Business Media LLC. - 0090-6964 .- 1573-9686. ; 39:1, s. 277-286
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Tidskriftsartikel (refereegranskat)abstract
- Recent studies have shown that the maximum transverse diameter of an abdominal aortic aneurysm (AAA) and expansion rate are not entirely reliable indicators of rupture potential. We hypothesize that aneurysm morphology and wall thickness are more predictive of rupture risk and can be the deciding factors in the clinical management of the disease. A non-invasive, image-based evaluation of AAA shape was implemented on a retrospective study of 10 ruptured and 66 unruptured aneurysms. Three-dimensional models were generated from segmented, contrast-enhanced computed tomography images. Geometric indices and regional variations in wall thickness were estimated based on novel segmentation algorithms. A model was created using a J48 decision tree algorithm and its performance was assessed using ten-fold cross validation. Feature selection was performed using the chi(2)-test. The model correctly classified 65 datasets and had an average prediction accuracy of 86.6% (kappa = 0.37). The highest ranked features were sac length, sac height, volume, surface area, maximum diameter, bulge height, and intra-luminal thrombus volume. Given that individual AAAs have complex shapes with local changes in surface curvature and wall thickness, the assessment of AAA rupture risk should be based on the accurate quantification of aneurysmal sac shape and size.
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| 10. |
- Shum, Judy, et al.
(författare)
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Quantitative assessment of abdominal aortic aneurysm geometry and rupture potential
- 2009
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Ingår i: PROCEEDINGS OF THE ASME SUMMER BIOENGINEERING CONFERENCE - 2009, PT A AND B. - 9780791848913 ; , s. 1303-1304
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Konferensbidrag (refereegranskat)abstract
- Recent biomechanics studies have shown that the maximum transverse diameter of an abdominal aortic aneurysm (AAA) and its expansion rate are not reliable indicators of rupture potential. We hypothesize that geometrical shape and size, as well as wall thickness may be related to rupture risk and can therefore be deciding factors in the clinical management of the disease. A non-invasive, image-based evaluation of AAA size and geometry was implemented on a retrospective study of twenty subjects. The contrast enhanced, computed tomography (CT) scans of 10 patients who suffered AAA rupture within 1 month of the scan were compared to those of 10 patients who received elective repair. The images were segmented and three-dimensional models were generated. Twenty-eight geometry-based indices were calculated to characterize the size and shape of each AAA and regional variations in wall thickness were estimated. A multivariate analysis of variance was performed for all indices comparing the ruptured and non-ruptured data sets to determine which indices are statistically significant. Receiving Operating Characteristic (ROC) curves were generated to determine the indices' potential as predictors of rupture risk. In addition to maximum diameter, five other geometry-based indices were found to be statistically significant, with the minimum wall thickness being the best discriminator between ruptures and non-ruptured AAAs.
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| 11. |
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| 12. |
- Shum, Judy, et al.
(författare)
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Semiautomatic vessel wall detection and quantification of wall thickness in computed tomography images of human abdominal aortic aneurysms
- 2010
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Ingår i: Medical physics (Lancaster). - : Wiley. - 0094-2405. ; 37:2, s. 638-648
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Quantitative measurements of wall thickness in human abdominal aortic aneurysms (AAAs) may lead to more accurate methods for the evaluation of their biomechanical environment. Methods: The authors describe an algorithm for estimating wall thickness in AAAs based on intensity histograms and neural networks involving segmentation of contrast enhanced abdominal computed tomography images. The algorithm was applied to ten ruptured and ten unruptured AAA image data sets. Two vascular surgeons manually segmented the lumen, inner wall, and outer wall of each data set and a reference standard was defined as the average of their segmentations. Reproducibility was determined by comparing the reference standard to lumen contours generated automatically by the algorithm and a commercially available software package. Repeatability was assessed by comparing the lumen, outer wall, and inner wall contours, as well as wall thickness, made by the two surgeons using the algorithm. Results: There was high correspondence between automatic and manual measurements for the lumen area (r=0.978 and r=0.996 for ruptured and unruptured aneurysms, respectively) and between vascular surgeons (r=0.987 and r=0.992 for ruptured and unruptured aneurysms, respectively). The authors' automatic algorithm showed better results when compared to the reference with an average lumen error of 3.69%, which is less than half the error between the commercially available application Simpleware and the reference (7.53%). Wall thickness measurements also showed good agreement between vascular surgeons with average coefficients of variation of 10.59% (ruptured aneurysms) and 13.02% (unruptured aneurysms). Ruptured aneurysms exhibit significantly thicker walls (1.78±0.39 mm) than unruptured ones (1.48±0.22 mm), p=0.044. Conclusions: While further refinement is needed to fully automate the outer wall segmentation algorithm, these preliminary results demonstrate the method's adequate reproducibility and low interobserver variability.
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