Previous analyses of aortic displacement and distension using computed tomography angiography (CTA) were performed on double-oblique multi-planar reformations and did not consider through-plane motion. The aim of this study was to overcome this limitation by using a novel computational approach for the assessment of thoracic aortic displacement and distension in their true four-dimensional extent. Vessel segmentation with landmark tracking was executed on CTA of 24 patients without evidence of aortic disease. Distension magnitudes and maximum displacement vectors (MDV) including their direction were analyzed at 5 aortic locations: left coronary artery (COR), mid-ascending aorta (ASC), brachiocephalic trunk (BCT), left subclavian artery (LSA), descending aorta (DES). Distension was highest for COR (2.3 ± 1.2 mm) and BCT (1.7 ± 1.1 mm) compared with ASC, LSA, and DES (p < 0.005). MDV decreased from COR to LSA (p < 0.005) and was highest for COR (6.2 ± 2.0 mm) and ASC (3.8 ± 1.9 mm). Displacement was directed towards left and anterior at COR and ASC. Craniocaudal displacement at COR and ASC was 1.3 ± 0.8 and 0.3 ± 0.3 mm. At BCT, LSA, and DES no predominant displacement direction was observable. Vessel displacement and wall distension are highest in the ascending aorta, and ascending aortic displacement is primarily directed towards left and anterior. Craniocaudal displacement remains low even close to the left cardiac ventricle.
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Weber TF, Ganten MK, Böckler D, Geisbüsch P, Kauczor HU, von Tengg-Kobligk H (2009) Heartbeat-related displacement of the thoracic aorta in patients with chronic aortic dissection type B: quantification by dynamic CTA. Eur J Radiol 72(3):483–488
Weber TF, Ganten MK, Böckler D et al (2009) Assessment of thoracic aortic conformational changes by four-dimensional computed tomography angiography in patients with chronic aortic dissection type b. Eur Radiol 19(1):245–253
Beller CJ, Labrosse MR, Thubrikar MJ, Robicsek F (2008) Finite element modeling of the thoracic aorta: including aortic root motion to evaluate the risk of aortic dissection. J Med Eng Technol 32(2):167–170
Rengier F, Weber TF, Henninger V et al (2012) Heartbeat-related distension and displacement of the thoracic aorta in healthy volunteers. Eur J Radiol 81(1):158–164
Biesdorf A, Wörz S, Müller T et al (2011) Model-based segmentation and motion analysis of the thoracic aorta from 4D ECG-gated CTA images. Med Image Comput Comput Assist Interv 14(Pt 1):589–596
Beller CJ, Labrosse MR, Hagl S, Gebhard MM, Karck M (2008) Aortic root motion remodeling after aortic valve replacement—implications for late aortic dissection. Interact Cardiovasc Thorac Surg 7(3):407–411 discussion 411
Beller CJ, Labrosse MR, Thubrikar MJ, Szabo G, Robicsek F, Hagl S (2005) Increased aortic wall stress in aortic insufficiency: clinical data and computer model. Eur J Cardiothorac Surg 27(2):270–275
Lang RM, Bierig M, Devereux RB et al (2005) Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 18(12):1440–1463
Johnson TR, Nikolaou K, Fink C et al (2007) Dual-source CT in chest pain diagnosis. Radiologe 47(4):301–309
Wörz S, von Tengg-Kobligk H, Henninger V et al (2010) 3-D quantification of the aortic arch morphology in 3-D CTA data for endovascular aortic repair. IEEE Trans Biomed Eng 57(10):2359–2368
Beller CJ, Labrosse MR, Thubrikar MJ, Robicsek F (2004) Role of aortic root motion in the pathogenesis of aortic dissection. Circulation 109(6):763–769
Ye C, Chang G, Li S et al (2011) Endovascular stent-graft treatment for Stanford type A aortic dissection. Eur J Vasc Endovasc Surg 42(6):787–794
Hinchliffe RJ, Thompson MM (2011) Comments regarding endovascular stent-graft treatment for Stanford type A aortic dissection. Eur J Vasc Endovasc Surg 42(6):795–796
Sobocinski J, O’Brien N, Maurel B et al (2011) Endovascular approaches to acute aortic type A dissection: a CT-based feasibility study. Eur J Vasc Endovasc Surg 42(4):442–447
van Prehn J, Vincken KL, Muhs BE et al (2007) Toward endografting of the ascending aorta: insight into dynamics using dynamic cine-CTA. J Endovasc Ther 14(4):551–560
Muhs BE, Vincken KL, van Prehn J et al (2006) Dynamic cine-CT angiography for the evaluation of the thoracic aorta; insight in dynamic changes with implications for thoracic endograft treatment. Eur J Vasc Endovasc Surg 32(5):532–536
Kozerke S, Scheidegger MB, Pedersen EM, Boesiger P (1999) Heart motion adapted cine phase-contrast flow measurements through the aortic valve. Magn Reson Med 42(5):970–978
Emilsson K, Egerlid R, Nygren BM (2006) Comparison between aortic annulus motion and mitral annulus motion obtained using echocardiography. Clin Physiol Funct Imaging 26(5):257–262
Beller CJ, Labrosse MR, Thubrikar MJ, Szabo G, Robicsek F, Hagl S (2005) Are there surgical implications to aortic root motion? J Heart Valve Dis 14(5):610–615
Beller CJ, Maurer T, Labrosse MR, Mesana T, Karck M, Veinot JP (2009) Gender-specific differences in aortic sinus curvature during aging: an anatomical and computational study. Cardiovasc Pathol 18(3):148–155
Burman ED, Keegan J, Kilner PJ (2008) Aortic root measurement by cardiovascular magnetic resonance: specification of planes and lines of measurement and corresponding normal values. Circ Cardiovasc Imaging 1(2):104–113
de Heer LM, Budde RP, Mali WP, de Vos AM, van Herwerden LA, Kluin J (2011) Aortic root dimension changes during systole and diastole: evaluation with ECG-gated multidetector row computed tomography. Int J Cardiovasc Imaging 27(8):1195–1204
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Weber, T.F., Müller, T., Biesdorf, A. et al. True four-dimensional analysis of thoracic aortic displacement and distension using model-based segmentation of computed tomography angiography. Int J Cardiovasc Imaging 30, 185–194 (2014) doi:10.1007/s10554-013-0307-6
- Thoracic aorta
- Computer-assisted image interpretation
- Cardiac-gated imaging techniques
- X-ray computed tomography