Influence of age and sex on aortic distensibility assessed by MRI in healthy subjects

Magnetic resonance imaging (MRI) is particularly well adapted to the evaluation of aortic distensibility. The calculation of this parameter, based on the change in vessel cross-sectional area per unit change in blood pressure, requires precise delineation of the aortic wall on a series of cine-MR images. Firstly, the study consisted in validating a new automatic method to assess aortic elasticity. Secondly, aortic distensibility was studied for the ascending and descending thoracic aortas in 26 healthy subjects. Two homogeneous groups were available to evaluate the influence of sex and age (with an age limit value of 35 years). The automatic postprocessing method proved to be robust and reliable enough to automatically determine aortic distensibility, even on artefacted images. In the 26 healthy volunteers, a marked decrease in distensibility appears with age, although this decrease is only significant for the ascending aorta (8.97±2.69 10⁻³ mmHg⁻¹ vs. 5.97±2.02 10⁻³ mmHg⁻¹). Women have a higher aortic distensibility than men but only significantly at the level of the descending aorta (7.20±1.61 10⁻³ mmHg⁻¹ vs. 5.05±2.40 10⁻³ mmHg⁻¹). Through our automatic contouring method, the aortic distensibility from routine cine-MRI has been studied on a healthy subject population providing reference values of aortic stiffness. The aortic distensibility calculation shows that age and sex are causes of aortic stiffness variations in healthy subjects.     

Application of multivariate analysis of TOF-SIMS spectra for studying the effect of high glucose intake on aortic lipid profile

Aim

To study the effect of long-term glucose feeding on aortic lipid composition by using the time of flight-secondary ion mass spectrometry (TOF-SIMS).

Method

Rats were divided into two groups, drinking water with or without 10% glucose from birth to 6 months of age. The aortic wall was dissected out, high-pressure frozen, freeze-fractured, freeze-dried and analyzed by TOF-SIMS using a Bismuth cluster ion source. Surface spectra were taken from standardized regions of the vessel wall.

Results

Different peaks, such as cholesterol, fatty acids (FAs) and diacylglycerols (DAGs), were identified by the principal component analysis as carries of variance between two groups. These peaks were then compared by conventional t-test. Our data showed that the intensity of cholesterol, but not FAs and DAGs, was significantly decreased in the glucose-drinking rat. Moreover, the long-term glucose intake changed ratios between different FAs in the aorta.

Conclusion

The long-term glucose intake led to decreased cholesterol intensity in the aortic wall and this effect was revealed through a global analytical approach with objective selection of significant variables.     

Co-registration of the distribution of wall shear stress and 140 complex plaques of the aorta

Previous studies provide evidence that atherosclerosis develops in vascular regions exposed to low wall shear stress (WSS) and high oscillatory shear index (OSI). 4D flow MRI was analyzed in 70 stroke patients with complex plaques (≥ 4 mm thickness, ulcerated or superimposed thrombi) and in 12 young healthy volunteers. The segmental distribution of peak systolic WSS_systole and OSI was quantified in analysis planes positioned directly at the location of 140 complex plaques found in the 70 patients. In addition, WSS_systole and OSI were evaluated in 8 standard analysis planes distributed along the aorta. Complex plaques were predominantly found at the inner curvature of the aortic arch and of the descending aorta. High OSI was co-located with the segments mostly affected by complex plaque while WSS_systole demonstrated a homogenous distribution. In standard analysis planes, patients demonstrated significantly (p < 0.01) altered distribution of wall parameters compared to volunteers (reduced WSS_systole in 91% of aortic wall segments, increased OSI in 48% of segments). OSI distribution was asymmetric with higher values at the inner curvature of the aorta. While WSS and OSI showed expected changes in patients compared to healthy controls, their distribution pattern at complex plaques indicated a more complex and heterogeneous relationship than previously anticipated.     

Optimized 3D bright blood MRI of aortic plaque at 3 T

PURPOSE: To evaluate the feasibility of an optimized bright blood MRI protocol at 3 T in combination with contrast agent administration for the detection and characterization of aortic high-risk plaques for the improved workup of acute stroke patients. MATERIALS AND METHODS: ECG synchronized T1-weighted 3D gradient echo MRI was performed in 45 acute stroke patients. Data were acquired with high near isotropic spatial resolution (approximately 1 mm(3)) covering the entire thoracic aorta. To compensate for breathing and vessel motion artifacts, images were collected using respiratory navigator gating in combination with short diastolic data acquisition windows adjusted on a patient-by-patient basis. In patients with aortic plaques > or =3 mm in thickness, gadolinium contrast agent was administered and both pre- and post-contrast T1-weighted 3D measurements with identical vessel coverage were performed. RESULTS: Bright blood 3D MRI detected 33 high-risk plaques with an average maximum plaque thickness of 4.2+/-1.0 mm in 23 of 45 acute stroke patients. The availability of pre- and post-contrast images acquired within the same session enhanced the identification of calcified plaque components in 77% of all analyzed plaques: post-contrast MRI clearly improved the delineation of hypointense plaque cores in 23 of 30 cases and assisted in the classification of core shape and of core fraction. CONCLUSION: 3D bright blood MRI at 3 T was feasible for the detection of aortic high-risk sources and may help to improve the detection of causes of cerebral embolism in acute stroke patients.     

MRI postoperative monitoring in patients surgically treated for aortic dissection

In most cases, surgery of aortic dissections repairs only the ascending portion of the aorta, leaving a residual dissection in the arch and descending aorta. We studied 17 patients operated upon for type A aortic dissection. A total of 42 magnetic resonance imaging (MRI) examinations were performed, with two to five studies per patient (mean 2.47). The studies were done between 5 weeks and 47 months (mean 17.5 months) after surgery. The patients were evaluated by MRI using gated spin-echo and gradient-echo sequences on axial and oblique sagittal views, and in selected cases, coronal views. A high incidence of abnormalities was observed. Pericardial hematoma was observed in 11% of cases, aortic and branch involvement in 41%, abdominal aortic branch involvement in 47%, dilatation of native aorta in 58%, and extension of dissection in 10%. New complications were detected during follow-up in 53% of patients. MRI was helpful in the follow-up of patients operated upon for aortic dissections, owing to its noninvasiveness and multiplanarity. By means of this technique, it was possible to obtain information about the natural history of the disease, as well as information useful for subsequent treatment.     

不同组织多普勒技术对高血压病左心室不同几何构型阶段主动脉壁平滑肌运动定量分析研究

目的探讨应用不同组织多普勒技术评估高血压病不同左心室几何构型阶段主动脉壁平滑肌运动的价值.方法测定高血压病患者主动脉壁的组织速度显像、组织追踪显像、应变显像和应变率显像曲线,并且分别测量每一曲线上的收缩期峰值速度(AOPVs)、舒张早期运动速度(AOVe)、舒张晚期运动速度(AOVa)、收缩期峰值位移(AOPDs)、收缩期峰值应变(AOPSs)、收缩期峰值应变率(AOPSRs)、舒张早期应变率(AOEsr)、舒张晚期应变率(AOAsr);并计算AOVe/AOVa,AOEsr/AOAsr.结果对照组与正常构型组、向心性重构组、向心性肥厚组、离心性肥厚组的AOPSs、AOVe、AOVa、AOEsr、AOEsr/Asr测值,向心性重构组、向心性肥厚组、离心性肥厚组的AOPDs测值,正常构型组、向心性重构组、向心性肥厚组的AOVe/Va测值差异均有统计学意义(均P<0.05);正常构型组与对照组、向心性重构组、向心性肥厚组、离心性肥厚组的AOPVs、AOPDs测值差异均有统计学意义(均P<0.05);向心性重构组与对照组、向心性肥厚组、离心性肥厚组的AOPVs测值,正常构型组、向心性肥厚组、离心性肥厚组的 AOPSs测值差异均有统计学意义(均P<0.05);离心性肥厚组与对照组、正常构型组、向心性重构组、向心性肥厚组的AOAsr、AOVe/Va测值差异均有统计学意义(均P<0.05);正常构型组、离心性肥厚组与对照组、向心性重构组、向心性肥厚组的AOPSRs测值、正常构型组、向心性重构组与向心性肥厚组、离心性肥厚组的AOEsr/Asr测值差异具有统计学意义(均P<0.05).结论(1)组织多普勒技术可评价高血压病不同左心室几何构型阶段的主动脉壁平滑肌的运动;(2)利用组织多普勒参数可定量评估高血压病在不同左心室几何构型阶段主动脉壁平滑肌的功能.     

In vivo characterization of the aortic wall stress-strain relationship

Arterial stiffness has been shown to be a good indicator of arterial wall disease. However, a single parameter is insufficient to describe the complex stress-strain relationship of a multi-component, non-linear tissue such as the aorta. We therefore propose a new approach to measure the stress-strain relationship locally in vivo noninvasively, and present a clinically relevant parameter describing the mechanical interaction between aortic wall constituents. The slope change of the circumferential stress-strain curve was hypothesized to be related to the contribution of elastin and collagen, and was defined as the transition strain (). A two-parallel spring model was employed and three Young’s moduli were accordingly evaluated, i.e., corresponding to the: elastic lamellae (E₁), elastin-collagen fibers (E₂) and collagen fibers (E₃). Our study was performed on normal and Angiotensin II (AngII)-treated mouse abdominal aortas using the aortic pressure after catheterization and the local aortic wall diameters change from a cross-correlation technique on the radio frequency (RF) ultrasound signal at 30 MHz and frame rate of 8 kHz. Using our technique, the transition strain and three Young’s moduli in both normal and pathological aortas were mapped in 2D. The slope change of the circumferential stress-strain curve was first observed in vivo under physiologic conditions. The transition strain was found at a lower strain level in the AngII-treated case, i.e., 0.029 ± 0.006 for the normal and 0.012 ± 0.004 for the AngII-treated aortas. E₁, E₂ and E₃ were equal to 69.7 ± 18.6, 214.5 ± 65.8 and 144.8 ± 55.2 kPa for the normal aortas, and 222.1 ± 114.8, 775.0 ± 586.4 and 552.9 ± 519.1 kPa for the AngII-treated aortas, respectively. This is because of the alteration of structures and content of the wall constituents, the degradation of elastic lamella and collagen formation due to AngII treatment. While such values illustrate the alteration of structure and content of the wall constituents related to AngII treatment, limitations regarding physical assumptions (isotropic, linear elastic) should be kept in mind. The transition strain, however, was shown to be a pressure independent parameter that can be clinically relevant and noninvasively measured using ultrasound-based motion estimation techniques. In conclusion, our novel methodology can assess the stress-strain relationship of the aortic wall locally in vivo and quantify important parameters for the detection and characterization of vascular disease.     

Assessment of stiffness changes in the ex vivo porcine aortic wall using magnetic resonance elastography

Magnetic resonance elastography (MRE) is a noninvasive phase-contrast technique for estimating the mechanical properties of tissues by imaging propagating mechanical waves within the tissue. In this study, we hypothesize that changes in arterial wall stiffness, experimentally induced by formalin fixation, can be measured using MRE in ex vivo porcine aortas. In agreement with our hypothesis, the significant stiffness increase after sample fixation was clearly demonstrated by MRE and confirmed by mechanical testing. The results indicate that MRE can be used to examine the stiffness changes of the aorta. This study has provided evidence of the effectiveness of using MRE to directly assess the stiffness change in aortic wall. The results offer motivation to pursue MRE as a noninvasive method for the evaluation of arterial wall mechanical properties.