can we predict abdominal aortic aneurysm (aaa) progression and rupture by non-invasive imaging—a systematic review我们可以预测腹主动脉瘤(aaa)进展和破裂的非侵入性的想象一种系统评价.pdfVIP

International Journal of Clinical Medicine, 2011, 2, 484-499 doi:10.4236/ijcm.2011.24083 Published Online September 2011 (http://www.SciRP.org/journal/ijcm) Can We Predict Abdominal Aortic Aneurysm (AAA) Progression and Rupture by Non-Invasive Imaging?—A Systematic Review * Abeera Abbas, Rizwan Attia, Alberto Smith, Matthew Waltham King’s College London British Heart Foundation Centre of Research Excellence, Academic Department of Surgery, Cardiovascular Division, NIHR Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College Hospital, London, UK. * Email: matthew.waltham@kcl.ac.uk Received June 22nd, 2011; revised August 8th, 2011; accepted August 20th, 2011. ABSTRACT Introduction : The most commonly used predictor of aneurysm behavior in clinical decision-making is size. There are however small aneurysms that rupture and certain large aneurysms remain asymptomatic. There is growing evidence to suggest that other variables may provide better information on metabolic and physiological properties of aortic wall and therefore better predict aneurysm behavior. Methods : The literature was systematically reviewed from 1975-May 2011 to examine the evidence to support the use of non-invasive imaging modalities that might predict aneurysm be- havior. Results : Ultrasound can be used to measure multiple dynamic aortic properties (i.e. distensibility and compli- ance) in addition to diameter. These parameters better predict aneurysm behavior. Computer tomography can utilize assessment of aortic calcification, presence of intra-luminal thrombus and distensibility. Finite element analysis model has been validated in-vivo to calculate peak wall stress, assess effects of intra-luminal thrombus and calcification. It however relies on assumptions related to aneurysm properties and therefore remains relatively inaccurate in the cl