Abstract

BackgroundThe thoracic aortic aneurysm (TAA) is a pathology that involves an expansion of the aortic diameter in the thoracic aorta, leading to risk of rupture. Recent studies have suggested that internal wall stress, which is affected by TAA geometry and the presence or absence of thrombus, is a more reliable predictor of rupture than the maximum diameter, the current clinical criterion. Accurate reconstruction of TAA geometry is a crucial step in patient-specific stress calculations.MethodsIn this work, a novel methodology was developed, which combines data from several sets of magnetic resonance (MR) images with different levels of detail and different resolutions. Two sets of images were employed to create the final model, which has the highest level of detail for each component of the aneurysm (lumen, thrombus, and wall). A reference model was built by using a single set of images for comparison. This approach was applied to two patient-specific TAAs in the descending thoracic aorta.ResultsThe results of finite element simulations showed differences in stress pattern between the coarse and fine models: higher stress values were found with the coarse model and the differences in predicted maximum wall stress were 30% for patient A and 11% for patient B.ConclusionThis paper presents a new approach to the reconstruction of an aneurysm model based on the use of several sets of MR images. This enables more accurate representation of not only the lumen but also the wall surface of a TAA taking account of intraluminal thrombus.

Highlights

  • The thoracic aortic aneurysm (TAA) is a pathology that involves an expansion of the aortic diameter in the thoracic aorta, leading to risk of rupture

  • Recent studies focused on abdominal aortic aneurysms have shown that peak wall stress in the aortic wall, calculated by means of the finite element method, is a more reliable parameter [2]

  • This paper presents a new approach to the reconstruction of patient-specific aneurysm models, based on the use of different magnetic resonance (MR) imaging sequences

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Summary

Introduction

The thoracic aortic aneurysm (TAA) is a pathology that involves an expansion of the aortic diameter in the thoracic aorta, leading to risk of rupture. Recent studies have suggested that internal wall stress, which is affected by TAA geometry and the presence or absence of thrombus, is a more reliable predictor of rupture than the maximum diameter, the current clinical criterion. The only criterion for the selection of surgical patients is based on the maximum diameter of the aneurysm, which has been proved not to be completely reliable for the assessment of the rupture risk. Recent studies focused on abdominal aortic aneurysms have shown that peak wall stress in the aortic wall, calculated by means of the finite element method, is a more reliable parameter [2]. The segmentation of the (page number not for citation purposes)

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