Abstract

Abdominal aortic aneurysm (AAA) is a critical condition with high rupture risk, and the maximum diameter alone is insufficient for prediction. Pulse wave velocity (PWV), a surrogate of aortic stiffness, can be estimated using 4D-Flow magnetic resonance imaging (MRI), but requires validation under dilated conditions. This in vitro study examined the relationship between PWV and stiffness by comparing healthy and aneurysmal compliant aortic models. Two latex phantoms were fabricated to represent normal and AAA geometries. A circulatory MRI-compatible system simulated physiological inlet flow, with flow rates measured across perpendicular planes using 4D- and 2D-Flow MRI. PWV was derived from transit times of the systolic upstroke and interplane distances. Complementary 1D numerical simulations and laboratory flowmeter measurements were performed. Although the wall elasticity and thickness were identical, PWV in the healthy model ranged from 6.2 to 7.7 m/s and in the aneurysmal model it ranged from 14.2 to 15 m/s. This increase was confirmed by temporal overlap of thoracic flow curves and reduced slope in the transit time–distance regression. Results were consistent across simulations, 2D-Flow, and flowmeter data. Findings highlight that indirect 4D-Flow assessment of thoracic stiffness in the presence of AAA must account for wave reflections introduced by dilation, which significantly alter PWV estimation.

IPC Classification

Keywords