Value of aortic volumes assessed by automated segmentation of 3D MRI data in patients with thoracic aortic dilatation: A case-control study
Résumé
Abstract
Purpose
The purpose of this study was to investigate the added value of aortic volumes compared to diameters or cross-sectional areas in separating patients with dilated aorta from matched controls.
Materials and Methods
Patients with tricuspid aortic valve and ATAA (TAV-ATAA: n=62, 15 women, median age 66 (60;75)[33-86] years) and patients with bicuspid aortic valve and dilated ascending aorta (BAV: n=43, 8 women, 51 (39;66)[17-76] years) were studied. Two control groups were matched by age and sex to TAV-ATAA (n=54, 15 women, 68 (59;73)[33-81] years) and BAV (n=42, 8 women, 50 (40;66)[17-77] years). All participants underwent 3D-MRI, used for 3D-segmentation for measuring aortic length, maximal diameter, maximal cross-sectional area (CSA) and volume for the ascending aorta (AAo).
Results
An increase in AAo volume (TAV-ATAA: +107%; BAV: +171% vs. controls, P<0.001) was found, which was 3 times higher than the increase in diameter (TAV-ATAA: +29%; BAV: +40% vs controls, P<0.001). Indexed aortic length, maximal diameter and CSA showed lower performance than volume (area under ROC curve [AUC], accuracy(%)=0.935 (0.882-0.989), 88.7 (82.9-94.5) for TAV-ATAA; 0.908 (0.829-0.987), 88.0 (80.9-95.0) for BAV vs. controls) in differentiating patients from their matched controls (AUC, accuracy(%), P-value for ROC comparisons against volume for TAV-ATAA: length=0.820(0.739-0.901), 78.3(70.7-85.8), <0.001, maximal diameter=0.867(0.795-0.939), 80.9(73.7-88.1), 0.003, CSA=0.900(0.836-0.964), 82.6(75.7-89.5), 0.03; BAV: length=0.827(0.730-0.924), 78.3(69.4-87.2), 0.02, maximal diameter=0.876(0.789-0.963), 83.1(75.1-91.2), 0.07, CSA=0.900(0.819-0.981), 86.8(79.5-94.0), 0.27).
Conclusions
Aortic volume measured by 3D-MRI integrates both elongation and luminal dilation, resulting in greater classification performance than maximal diameter and length in differentiating patients with dilated AAo or aneurysm from controls.
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