ABSTRACT
PURPOSE: To investigate the use of regional variations in the mechanical properties of abdominal aortic aneurysms (AAA) in finite element (FE) modeling of AAA rupture risk, which has heretofore assumed homogeneous mechanical tissue properties. METHODS: Electrocardiogram-gated computed tomography scans from 3 male patients with known infrarenal AAA were used to characterize the behavior of the aneurysm in 4 different segments (posterior, anterior, and left and right lateral) at maximum diameter and above the infrarenal aorta. The elasticity of the aneurysm (circumferential cyclic strain, compliance, and the Hudetz incremental modulus) was calculated for each segment and the aneurysm as a whole. The FE analysis inclusive of prestress (pre-existing tensile stress) produced a detailed stress pattern on each of the aneurysm models under pressure loading. The 4 largest areas of stress in each region were considered in conjunction with the local regional properties of the segment to define a specific regional prestress rupture index (RPRI). RESULTS: In terms of elasticity, there were average reductions of 68% in circumferential cyclic strain and 63% in compliance, with a >5-fold increase in incremental modulus, between the healthy and the aneurysmal aorta for each patient. There were also regional variations in all elastic properties in each individual patient. The average difference in total stress inclusive of prestress was 59%, 67%, and 15%, respectively, for the 3 patients. Comparing the strain from FE models with the CT scans revealed an average difference in strain of 1.55% for the segmented models and 3.61% for the homogeneous models, which suggests that the segmented models more accurately reflect in vivo behavior. RPRI values were calculated for each segment for all patients. CONCLUSION: A greater understanding of the local material properties and their use in FE models is essential for greater accuracy in rupture prediction. Quantifying the regional behavior will yield insight into the changes in patient-specific aneurysms and increase understanding about the progression of aneurysmal disease.
Subject(s)
Aorta, Abdominal , Aortic Aneurysm, Abdominal/complications , Aortic Rupture/etiology , Computer Simulation , Finite Element Analysis , Models, Cardiovascular , Aged , Aged, 80 and over , Aorta, Abdominal/diagnostic imaging , Aorta, Abdominal/pathology , Aorta, Abdominal/physiopathology , Aortic Aneurysm, Abdominal/diagnostic imaging , Aortic Aneurysm, Abdominal/pathology , Aortic Aneurysm, Abdominal/physiopathology , Aortic Rupture/diagnostic imaging , Aortic Rupture/pathology , Aortic Rupture/physiopathology , Aortography/methods , Biomechanical Phenomena , Cardiac-Gated Imaging Techniques , Disease Progression , Elasticity , Electrocardiography , Hemodynamics , Humans , Male , Risk Assessment , Risk Factors , Stress, Mechanical , Tomography, X-Ray ComputedABSTRACT
An abdominal aortic aneurysm (AAA) is defined as a permanent and irreversible localized dilatation of the abdominal aorta. A reliable, non-invasive method to assess the wall mechanics of an aneurysm may provide additional information regarding their susceptibility to rupture. Acoustic radiation force impulse (ARFI) imaging is a phenomenon associated with the propagation of acoustic waves in attenuating media. This study was a preliminary evaluation to explore the feasibility of using ARFI imaging to examine an AAA in vivo. A previously diagnosed in vivo aneurysm case study was imaged to demonstrate the viability of excitation of the abdominal aorta using ARFI imaging. Ex vivo experiments were used to assess an artificially induced aneurysm to establish its development and whether ARFI was able to capture the mechanical changes during artificial aneurysm formation. A combination of in vivo and ex vivo results demonstrated a proposed hypothesis of estimation of the tissue's stiffness properties. The study details a method for non-invasive rupture potential prediction of AAAs using patient-specific moduli to generate a physiological stiffness rupture potential index (PSRPI) of the AAA. Clinical feasibility of ARFI imaging as an additional surgical tool to interrogate AAAs was verified and methods to utilize this data as a diagnostic tool was demonstrated with the PSRPI.
Subject(s)
Acoustics , Aortic Aneurysm, Abdominal/pathology , Aortic Rupture/pathology , Molecular Imaging/methods , Aged , Animals , Aortic Aneurysm, Abdominal/drug therapy , Aortic Aneurysm, Abdominal/physiopathology , Aortic Rupture/drug therapy , Aortic Rupture/physiopathology , Biomechanical Phenomena , Feasibility Studies , Female , Humans , Pancreatic Elastase/therapeutic use , Probability , SwineABSTRACT
A method for reliable, noninvasive estimation of abdominal aortic aneurysms (AAA) wall mechanics may be a useful clinical tool for rupture prediction. An in vitro AAA model was developed from an excised porcine aorta with elastase treatment. The AAA model behaviour was analysed using acoustic radiation force impulse (ARFI) imaging techniques to generate and measure wave propagation in both aneurysmal and normal aortic tissue. Opening angle measurement showed a fourfold decrease from healthy aorta to AAA model and pathologic analysis verified this elastin degradation. Maximum wave velocity at 180 mm Hg was 7 mm/ms for healthy tissue and 8.26 mm/ms for the aneurysmal tissue. The mechanical changes produced in the artificially induced aneurysm were found to be detectable using ARFI imaging.
