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Updated: Jun 14, 2025
Author Spotlight: Using Point-of-Care Ultrasound for Comprehensive Evaluation of the Abdominal Aorta
Published on: September 8, 2023
A morphological indicator for aortic dissection: fitting circle of the thoracic aorta
Hongji Pu1, Tao Peng2, Zhijue Xu1,3
1Department of Vascular Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
Insights
A novel method uses thoracic aorta geometry to detect aortic dissection (AD). Healthy aortas fit a circle, while AD aortas show significant deformation, indicating a new diagnostic indicator.
Area of Science:
- Cardiovascular Imaging
- Medical Diagnostics
- Biomedical Engineering
Background:
- Aortic dissection (AD) is a life-threatening condition requiring accurate diagnosis.
- Identifying reliable morphological indicators for AD is crucial for early detection and treatment.
Purpose of the Study:
- To identify a morphological indicator of aortic dissection (AD) based on the geometrical characteristics of the thoracic aorta.
- To evaluate the efficacy of a circle-fitting method in distinguishing between healthy and dissected aortas.
Main Methods:
- Computed tomographic angiograms from 63 AD patients and 71 healthy individuals were analyzed.
- Centerline extraction and spatial transformation were used to obtain 2D aortic morphology, which was then fitted to a circle.
- Multivariable logistic regression analysis validated the circle-fitting method for AD detection.
Main Results:
- Healthy thoracic aortas showed high similarity to a circle (sum of residuals: 3502.45 ± 2566.71, variance: 86.23 ± 56.60).
- Aortic dissection samples exhibited poorer circularity (sum of residuals: 5404.78 ± 3891.69, variance: 129.90 ± 90.09), with a significant difference (p < 0.001).
- Increased thoracic aorta deformation was a significant indicator of AD (odds ratio: 1.35, p = 0.034).
Conclusions:
- The morphology of healthy thoracic aortas can be accurately modeled as a circle.
- Dissected aortas demonstrate significantly poorer circularity, indicating aortic deformation.
- The circle-fitting method provides an effective statistical indicator for detecting aortic dissection.
Background:
This study aims to identify a morphological indicator of aortic dissection (AD) based on the geometrical characteristics of the thoracic aorta.
Methods:
We evaluated computed tomographic angiograms of 63 samples with AD (22 with type A AD, 41 with type B AD) and 71 healthy samples. Via centerline extraction and spatial transformation, the spatial entanglement of the aorta was minimized, and the expanded 2D aortic morphology was obtained. The 2D morphology of the thoracic aorta was fit to a circle. The applicability of the fitting circle method for identifying aortic dissection was verified by multivariable logistic regression analysis.
Results:
Via the 3D coordinate transformation algorithm, the optimal aortic view was obtained. On this view, the geometrical characteristics of the thoracic aortas of the healthy controls were similar to a portion of a circle (sum of residuals: 3502.45 ± 2566.71, variance: 86.23 ± 56.60), while that of AD samples had poorer similarity to the circle (sum of residuals: 5404.78 ± 3891.69, variance: 129.90 ± 90.09). This difference was significant (p < 0.001). A logistic regression model showed that increased deformation of the thoracic aorta was a significant indicator of aortic dissection (odds ratio: 1.35, p = 0.034).
Conclusions:
The morphology of the healthy thoracic aorta could be fit to a circle, while that of the dissected aorta had poorer similarity to the circle. The statistics of the circle are an effective indicator of aortic deformation in AD.
Trial Registration:
This study is registered in the Chinese Clinical Trial Registry (ChiCTR2000029219).
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