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International Angiology 2021 Oct 21

DOI: 10.23736/S0392-9590.21.04724-6


language: English

Profiling abdominal aortic aneurysm growth with three-dimensional ultrasound

Magdalena BRODA 1, 2 , Laurence ROUET 3, Alexander ZIELINSKI 1, 2, Henrik SILLESEN 1, 2, Jonas EIBERG 1, 2, 4, Qasam GHULAM 1

1 Department of Vascular Surgery, Rigshospitalet, Copenhagen, Denmark; 2 Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; 3 Philips Research, Suresnes, France; 4 Copenhagen Academy of Medical Education and Simulation (CAMES), Copenhagen, Denmark


BACKGROUND: “Profiling” is a new method based on three-dimensional ultrasound (3D-US) allowing for direct comparison of baseline and follow-up diameters along the AAA length. This study aimed to evaluate the feasibility of profiling to visualize AAA changes at sub-maximum diameters, and to categorize the growth profiles.
METHODS: Retrospective analysis of prospectively and consecutively included patients under AAA surveillance at a tertiary referral centre. 3D-US images of AAAs at baseline and at one-year follow-up were segmented, generating a centerline and a mesh of the aneurysm geometry. The mesh was processed to illustrate diameter changes of a given AAA. Three growth profiles were identified: A) Peak Growth: the largest, significant (≥3.6 mm) diameter difference occurred within a 10 mm margin to either side of the maximum baseline diameter; B) Edge Growth: at least one significant diameter difference and the criteria for Peak Growth did not apply; C) No Growth: all diameter differences were nonsignificant. A centerline length of ≥60 mm was assumed to capture a comparable segment of the wall geometry at baseline and follow-up. Cohen’s kappa and Kaplan Meier analysis were used to analyze data.
RESULTS: In total, 186 patients had growth profiles generated. Of these, 28 (15%) were discarded, mainly based on inadequate centerline lengths (n= 21, 11.3%). The remaining patients were categorized into Edge Growth (n=83, 52%), No Growth (n=47, 30%), and Peak Growth (n=28, 18%).
CONCLUSIONS: Profiling interprets AAA growth at sub-maximum diameters. Half of the cohort had Edge Growth. These AAAs risk being classified as stable.

KEY WORDS: Abdominal aortic aneurysm; Growth; Ultrasonography; Diagnostic imaging; Imaging; Three-dimensional

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