Abdominal aortic aneurysms (AAA) are life-threatening vascular dilations with rupture risk primarily assessed through geometric criteria such as maximal diameter. However, these static measures fail to capture the complex hemodynamics underlying disease progression. In this study, we present a novel, anatomically tailored virtual catheter method for 4D Flow MRI analysis of the abdominal aorta, aimed at extracting advanced hemodynamic biomarkers in both healthy volunteers and AAA patients. The catheter adapts to the vessel’s geometry and enables voxel-wise quantification of kinetic energy (KE), viscous energy loss (VEL), pressure gradient, and pulse wave velocity (PWV) across standardized anatomical landmarks. Our testing cohort included 12 volunteers and 12 AAA patients scanned preoperatively. The developed method enabled the high-resolution quantification of flow dynamics by integrating the assessment of 4D Flow MRI velocities. Compared to controls, AAA patients exhibited significantly lower peak KE (59.5 ± 26.2 vs. 186.9 ± 86.3 J/m3, p < 0.001), reduced pressure gradients (7.2 ± 3.0 vs. 15.1 ± 3.5 mmHg, p < 0.001), and diminished VEL (7.8 ± 6.1 vs. 22.1 ± 17.1 W/m3, p < 0.05), but higher PWV (9.1 ± 1.7 vs. 7.2 ± 1.3 m/s, p < 0.05), suggesting increased arterial stiffness. These results highlight key functional differences in aortic biomechanics between the groups. This study explored a new non-invasive method of AAA assessment using 4D Flow MRI. The proposed catheter-based tool could complement traditional imaging metrics, enhancing personalized risk stratification and potentially informing future clinical decision-making.

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Virtual Catheter for the Non-Invasive Assessment of Intra-Aortic Hemodynamics with 4D Flow MRI in Patients with Abdominal Aortic Aneurysms

  • Caterina Galafassi,
  • Florencia Rocca,
  • Mariano Ezequiel Casciaro,
  • Valentina Stipechi,
  • Damian Craiem

摘要

Abdominal aortic aneurysms (AAA) are life-threatening vascular dilations with rupture risk primarily assessed through geometric criteria such as maximal diameter. However, these static measures fail to capture the complex hemodynamics underlying disease progression. In this study, we present a novel, anatomically tailored virtual catheter method for 4D Flow MRI analysis of the abdominal aorta, aimed at extracting advanced hemodynamic biomarkers in both healthy volunteers and AAA patients. The catheter adapts to the vessel’s geometry and enables voxel-wise quantification of kinetic energy (KE), viscous energy loss (VEL), pressure gradient, and pulse wave velocity (PWV) across standardized anatomical landmarks. Our testing cohort included 12 volunteers and 12 AAA patients scanned preoperatively. The developed method enabled the high-resolution quantification of flow dynamics by integrating the assessment of 4D Flow MRI velocities. Compared to controls, AAA patients exhibited significantly lower peak KE (59.5 ± 26.2 vs. 186.9 ± 86.3 J/m3, p < 0.001), reduced pressure gradients (7.2 ± 3.0 vs. 15.1 ± 3.5 mmHg, p < 0.001), and diminished VEL (7.8 ± 6.1 vs. 22.1 ± 17.1 W/m3, p < 0.05), but higher PWV (9.1 ± 1.7 vs. 7.2 ± 1.3 m/s, p < 0.05), suggesting increased arterial stiffness. These results highlight key functional differences in aortic biomechanics between the groups. This study explored a new non-invasive method of AAA assessment using 4D Flow MRI. The proposed catheter-based tool could complement traditional imaging metrics, enhancing personalized risk stratification and potentially informing future clinical decision-making.