3D geometric reconstruction of thoracic aortic aneurysms

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.

[1]  Marcel Breeuwer,et al.  Segmentation of thrombus in abdominal aortic aneurysms from CTA with nonparametric statistical grey level appearance modeling , 2005, IEEE Transactions on Medical Imaging.

[2]  Jeffrey L Duerk,et al.  Toward rapid high resolution in vivo intravascular MRI: Evaluation of vessel wall conspicuity in a porcine model using multiple imaging protocols , 2006, Journal of magnetic resonance imaging : JMRI.

[3]  Gerhard A. Holzapfel,et al.  A Layer-Specific Three-Dimensional Model for the Simulation of Balloon Angioplasty using Magnetic Resonance Imaging and Mechanical Testing , 2002, Annals of Biomedical Engineering.

[4]  Dalin Tang,et al.  3D MRI-Based Multicomponent FSI Models for Atherosclerotic Plaques , 2004, Annals of Biomedical Engineering.

[5]  Rudolf Stollberger,et al.  3-D reconstruction of tissue components for atherosclerotic human arteries using ex vivo high-resolution MRI , 2006, IEEE Transactions on Medical Imaging.

[6]  J. Joyce,et al.  Aneurysms of the Thoracic Aorta: A Clinical Study with Special Reference to Prognosis , 1964, Circulation.

[7]  T. Ishimori,et al.  Dynamic subtraction contrast-enhanced MR angiography: technique, clinical applications, and pitfalls. , 2000, Radiographics : a review publication of the Radiological Society of North America, Inc.

[8]  N. Cheshire,et al.  Fluid structure interaction of patient specific abdominal aortic aneurysms: a comparison with solid stress models , 2006, Biomedical engineering online.

[9]  S. Napel,et al.  An abdominal aortic aneurysm segmentation method: level set with region and statistical information. , 2006, Medical physics.

[10]  X Y Xu,et al.  Magnetic resonance image processing and structured grid generation of a human abdominal bifurcation. , 1998, Computer methods and programs in biomedicine.

[11]  Mark F Fillinger,et al.  Prediction of rupture risk in abdominal aortic aneurysm during observation: wall stress versus diameter. , 2003, Journal of vascular surgery.

[12]  Yannis Papaharilaou,et al.  A decoupled fluid structure approach for estimating wall stress in abdominal aortic aneurysms. , 2007, Journal of biomechanics.

[13]  S. Rha,et al.  Gallbladder wall thickening: MR imaging and pathologic correlation with emphasis on layered pattern , 2005, European Radiology.

[14]  D A Vorp,et al.  Mechanical properties and microstructure of intraluminal thrombus from abdominal aortic aneurysm. , 2001, Journal of biomechanical engineering.

[15]  J. Coselli,et al.  Thoracoabdominal aortic aneurysms: preoperative and intraoperative factors determining immediate and long-term results of operations in 605 patients. , 1986, Journal of vascular surgery.

[16]  Yoko Kato,et al.  Development of a method to construct three-dimensional finite element models of thoracic aortic aneurysms from MRI images , 2001, Proceedings International Workshop on Medical Imaging and Augmented Reality.

[17]  Hongen Liao,et al.  Medical Imaging and Augmented Reality , 2004 .

[18]  Luca Antiga,et al.  Geometric reconstruction for computational mesh generation of arterial bifurcations from CT angiography. , 2002, Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society.

[19]  D A Steinman,et al.  Effect of black blood MR image quality on vessel wall segmentation , 2001, Magnetic resonance in medicine.

[20]  Eike Nagel,et al.  Segmentation of wall and plaque in in vitro vascular MR images , 2004, The International Journal of Cardiovascular Imaging.

[21]  M J Fagan,et al.  A comparative study of aortic wall stress using finite element analysis for ruptured and non-ruptured abdominal aortic aneurysms. , 2004, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[22]  M. Webster,et al.  Effect of intraluminal thrombus on wall stress in patient-specific models of abdominal aortic aneurysm. , 2002, Journal of vascular surgery.

[23]  Bartley P Griffith,et al.  Effect of aneurysm on the tensile strength and biomechanical behavior of the ascending thoracic aorta. , 2003, The Annals of thoracic surgery.

[24]  Sven Loncaric,et al.  Model-based quantitative AAA image analysis using a priori knowledge , 2005, Comput. Methods Programs Biomed..

[25]  Elena S. Di Martino,et al.  Fluid-structure interaction within realistic three-dimensional models of the aneurysmatic aorta as a guidance to assess the risk of rupture of the aneurysm. , 2001, Medical engineering & physics.

[26]  M L Raghavan,et al.  Toward a biomechanical tool to evaluate rupture potential of abdominal aortic aneurysm: identification of a finite strain constitutive model and evaluation of its applicability. , 2000, Journal of biomechanics.