Increasing the feasibility of minimally invasive procedures in type A aortic dissections: a framework for segmentation and quantification

  • Cosmin Adrian MorariuEmail author
  • Tobias Terheiden
  • Daniel Sebastian Dohle
  • Konstantinos Tsagakis
  • Josef Pauli
Original Article



Our goal is to provide precise measurements of the aortic dimensions in case of dissection pathologies. Quantification of surface lengths and aortic radii/diameters together with the visualization of the dissection membrane represents crucial prerequisites for enabling minimally invasive treatment of type A dissections, which always also imply the ascending aorta.


We seek a measure invariant to luminance and contrast for aortic outer wall segmentation. Therefore, we propose a 2D graph-based approach using phase congruency combined with additional features. Phase congruency is extended to 3D by designing a novel conic directional filter and adding a lowpass component to the 3D Log-Gabor filterbank for extracting the fine dissection membrane, which separates the true lumen from the false one within the aorta.


The result of the outer wall segmentation is compared with manually annotated axial slices belonging to 11 CTA datasets. Quantitative assessment of our novel 2D/3D membrane extraction algorithms has been obtained for 10 datasets and reveals subvoxel accuracy in all cases. Aortic inner and outer surface lengths, determined within 2 cadaveric CT datasets, are validated against manual measurements performed by a vascular surgeon on excised aortas of the body donors.


This contribution proposes a complete pipeline for segmentation and quantification of aortic dissections. Validation against ground truth of the 3D contour lengths quantification represents a significant step toward custom-designed stent-grafts.


Aortic dissection Endovascular repair Patient-specific stent-graft 2D/3D phase congruency Optimal path 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Animal/human studies

This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© CARS 2015

Authors and Affiliations

  • Cosmin Adrian Morariu
    • 1
    Email author
  • Tobias Terheiden
    • 1
  • Daniel Sebastian Dohle
    • 2
  • Konstantinos Tsagakis
    • 2
  • Josef Pauli
    • 1
  1. 1.Intelligent Systems, Faculty of EngineeringUniversity of Duisburg-EssenDuisburgGermany
  2. 2.Department of Thoracic and Cardiovascular SurgeryUniversity Clinic EssenEssenGermany

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