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Common First-Pass CT Angiography Findings Associated With Rapid Growth Rate in Abdominal Aorta Aneurysms Between 3 and 5 cm in Largest Diameter


Aghayev, Ayaz; Giannopoulos, Andreas A; Gronsbell, Jessica; George, Elizabeth; Cai, Tianxi; Steigner, Michael L; Mitsouras, Dimitrios; Rybicki, Frank J (2018). Common First-Pass CT Angiography Findings Associated With Rapid Growth Rate in Abdominal Aorta Aneurysms Between 3 and 5 cm in Largest Diameter. American Journal of Roentgenology, 210(2):431-437.

Abstract

OBJECTIVE The purpose of this study was to describe CT angiography (CTA) findings of lumen contrast heterogeneity and intraluminal thrombus volume and to evaluate their relationship with rapid aneurysm growth in patients with abdominal aortic aneurysms (AAA) between 3 and 5 cm. MATERIALS AND METHODS This institutional review board-approved and HIPAA-compliant single-center retrospective study included CTA studies obtained between January 2004 and December 2014 in 140 patients with AAA (101 men, 39 women; mean age ± SD, 70 ± 9 years old; age range, 22-87 years old). Standardized measurements for aneurysm intraluminal thrombus volume and a relatively new metric termed "lumen contrast heterogeneity" were obtained from the CTA images. AAA growth rate data were acquired from all subsequent cross-sectional studies. The association between the imaging findings and rapid aneurysm growth (> 0.4 cm/y) was evaluated using multivariate logistic regression. Patient comorbidities and medications were added to the regression model to assess for further associations with rapid growth rate. RESULTS Using a baseline logistic regression model, lumen contrast heterogeneity (odds ratio [OR], 1.16; 95% CI, 1.05-1.32), intraluminal thrombus volume (OR, 2.15; 95% CI, 1.26-3.86), and maximum AAA diameter (OR, 1.69; 95% CI, 1.03-2.84) were independently associated with increased likelihood of rapid aneurysm growth. None of the patient comorbidities or medications were significantly associated with the outcome when added to the baseline model. CONCLUSION Both intraluminal thrombus and lumen contrast heterogeneity are seen on AAA CTA studies and can be quantified; both of these metrics are independently associated with rapid growth rate and should be recognized by radiologists evaluating patients with AAA during surveillance.

Abstract

OBJECTIVE The purpose of this study was to describe CT angiography (CTA) findings of lumen contrast heterogeneity and intraluminal thrombus volume and to evaluate their relationship with rapid aneurysm growth in patients with abdominal aortic aneurysms (AAA) between 3 and 5 cm. MATERIALS AND METHODS This institutional review board-approved and HIPAA-compliant single-center retrospective study included CTA studies obtained between January 2004 and December 2014 in 140 patients with AAA (101 men, 39 women; mean age ± SD, 70 ± 9 years old; age range, 22-87 years old). Standardized measurements for aneurysm intraluminal thrombus volume and a relatively new metric termed "lumen contrast heterogeneity" were obtained from the CTA images. AAA growth rate data were acquired from all subsequent cross-sectional studies. The association between the imaging findings and rapid aneurysm growth (> 0.4 cm/y) was evaluated using multivariate logistic regression. Patient comorbidities and medications were added to the regression model to assess for further associations with rapid growth rate. RESULTS Using a baseline logistic regression model, lumen contrast heterogeneity (odds ratio [OR], 1.16; 95% CI, 1.05-1.32), intraluminal thrombus volume (OR, 2.15; 95% CI, 1.26-3.86), and maximum AAA diameter (OR, 1.69; 95% CI, 1.03-2.84) were independently associated with increased likelihood of rapid aneurysm growth. None of the patient comorbidities or medications were significantly associated with the outcome when added to the baseline model. CONCLUSION Both intraluminal thrombus and lumen contrast heterogeneity are seen on AAA CTA studies and can be quantified; both of these metrics are independently associated with rapid growth rate and should be recognized by radiologists evaluating patients with AAA during surveillance.

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Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Nuclear Medicine
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:February 2018
Deposited On:09 Feb 2018 14:26
Last Modified:20 Feb 2018 09:06
Publisher:American Roentgen Ray Society
ISSN:0361-803X
OA Status:Closed
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.2214/AJR.17.18094
PubMed ID:29261347

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