Quantification of abdominal aortic aneurysm stiffness using magnetic resonance elastography and its comparison to aneurysm diameter

• Published in: Journal of vascular surgery 2016-10, Vol.64 (4), p.966-974
• Main Authors: Kolipaka, Arunark, PhD, Illapani, Venkata Sita Priyanka, MS, Kenyhercz, William, MPH, Dowell, Joshua D., MD, PhD, Go, Michael R., MD, Starr, Jean E., MD, Vaccaro, Patrick S., MD, White, Richard D., MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aorta, Abdominal - diagnostic imaging; Aorta, Abdominal - physiopathology; Aortic Aneurysm, Abdominal - complications; Aortic Aneurysm, Abdominal - diagnostic imaging; Aortic Aneurysm, Abdominal - physiopathology; Aortic Rupture - etiology; Aortography - methods; Case-Control Studies; Computed Tomography Angiography; Dilatation, Pathologic; Elasticity Imaging Techniques - methods; Female; Humans; Magnetic Resonance Angiography; Male; Middle Aged; Predictive Value of Tests; Prognosis; Risk Factors; Statistics, Nonparametric; Surgery; Thrombosis - diagnostic imaging; Thrombosis - physiopathology; Vascular Calcification - diagnostic imaging; Vascular Calcification - physiopathology; Vascular Stiffness
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2016.03.426

Objective Abdominal aortic aneurysm (AAA) wall stiffness has been suggested to be an important factor in the overall rupture risk assessment compared with anatomic measure. We hypothesize that AAA diameter will have no correlation to AAA wall stiffness. The aim of this study is to (1) determine magnetic resonance elastography (MRE)-derived aortic wall stiffness in AAA patients and its correlation to AAA diameter; (2) determine the correlation between AAA stiffness and amount of thrombus and calcium; and (3) compare the AAA stiffness measurements against age-matched healthy individuals. Methods In vivo abdominal aortic MRE was performed on 36 individuals (24 patients with AAA measuring 3-10 cm and 12 healthy volunteers), aged 36 to 78 years, after obtaining written informed consent under the approval of the Institutional Review Board. MRE images were processed to obtain spatial stiffness maps of the aorta. AAA diameter, amount of thrombus, and calcium score were reported by experienced interventional radiologists. Spearman correlation, Wilcoxon signed rank test, and Mann-Whitney test were performed to determine the correlation between AAA stiffness and diameter and to determine the significant difference in stiffness measurements between AAA patients and healthy individuals. Results No significant correlation ( P > .1) was found between AAA stiffness and diameter or amount of thrombus or calcium score. AAA stiffness (mean 13.97 ± 4.2 kPa) is significantly ( P ≤ .02) higher than remote normal aorta in AAA (mean 8.87 ± 2.2 kPa) patients and in normal individuals (mean 7.1 ± 1.9 kPa). Conclusions Our results suggest that AAA wall stiffness may provide additional information independent of AAA diameter, which may contribute to our understanding of AAA pathophysiology, biomechanics, and risk for rupture.