Quantitative visualization assessment of the vascular wall in patients with surgical pathology of the aortic valve, aorta and brachiocephalic arteries

Objective: Identification of the quantitative characteristics of changes in the arterial wall according to ultrasound, CT and MRI; development of the roadmap for the use of radiology diagnostic methods.
Material and methods: 548 studies of 483 patients with atherosclerosis were analyzed (15 ultrasound studies, 483 – CTA and 50 – MRI). In the comparison group (n = 17) in patients without atherosclerosis, an analysis of MRI data of the aortic wall was performed. According to CTA, signs of atherosclerotic degeneration were assessed. According to the MRI data, indicators of aortic distensibility, Young’s modulus of the aortic wall (MPa), systolic distension of the aorta (ml), aortic wall enhancement index during contrast enhancement were calculated.
Results: During the performance of ultrasound in all cases (n = 15), the analysis of the elastic properties of the aortic wall is difficult due to the artifact from calcification. Adverse CT signs of the occurrence of intraoperative vascular complications: the presence of an intraluminal thrombus, an uneven internal aortic contour of more than half of the circumference with an aortic wall thickness of more than 5 mm. According to MRI data in patients with atherosclerosis, aortic distensibility was reduced to 14.42 ± 2.95%, Young’s modulus for the aortic wall was 0.77 ± 0.26 MPa, the index of contrast enhancement of the aortic wall was 1.73 ± 0.5, the volume of systolic aortic distension was 11.48 ± 1.84 ml. In patients with vascular events in the perioperative period, systolic aortic dilatation was 9.2 ml.
Conclusion: The signs which are expedient to consider when making a decision on surgical treatment have been identified. Significant limitations were identified in the assessment of elasticity by ultrasound. The wider use of MRI in atherosclerotic lesions looks promising.

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