Abdominal aortic aneurysms (AAA) are localized, commonly occurring aortic dilations. Following rupture only immediate treatment can prevent morbidity and mortality. AAA maximal diameter and growth are the current metrics to evaluate the associated risk and plan intervention. Although these criteria alone lack patient specificity, predicting their evolution would improve clinical decision. If the disease is known to be associated with altered morphology and blood flow, intraluminal thrombus deposit and clinical symptoms, the growth mechanisms are yet to be fully understood. In this retrospective longitudinal study of 138 scans, morphological analysis and blood flow simulations for 32 patients with clinically diagnosed AAAs and several follow-up CT-scans, are performed and compared to 9 control subjects. Several metrics stratify patients between healthy, low and high risk groups. Local correlations between hemodynamic metrics and AAA growth are also explored but due to their high inter-patient variability, do not explain AAA heterogeneous growth. Finally, high-risk predictors trained with successively clinical, morphological, hemodynamic and all data, and their link to the AAA evolution are built from supervise learning. Predictive performance is high for morphological, hemodynamic and all data, in contrast to clinical data. The morphology-based predictor exhibits an interesting effort-predictability tradeoff to be validated for clinical translation.

中文翻译：

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一项队列纵向研究确定了腹主动脉瘤生长的形态和血流动力学预测指标。

腹主动脉瘤（AAA）是局限性的，常见于主动脉扩张。破裂后，只有立即治疗才能预防发病和死亡。AAA最大直径和增长是评估相关风险和计划干预措施的当前指标。尽管仅这些标准缺乏患者特异性，但预测其发展将改善临床决策。如果已知该疾病与形态和血流改变，管腔内血栓沉积和临床症状有关，则其生长机理尚未完全了解。在这项对138次扫描的回顾性纵向研究中，对32例临床诊断为AAA的患者进行了形态学分析和血流模拟，并进行了多次随访CT扫描，并将其与9名对照对象进行了比较。几种指标将患者分为健康，低风险和高风险人群。还探讨了血流动力学指标和AAA增长之间的局部相关性，但是由于它们在患者之间的高度可变性，不能解释AAA异质性增长。最后，通过监督学习建立了经过连续临床，形态，血液动力学和所有数据训练的高风险预测因子，以及它们与AAA进化的联系。与临床数据相比，形态，血液动力学和所有数据的预测性能都很高。基于形态学的预测子表现出有趣的努力-可预测性折衷，需要进行临床翻译验证。最后，通过监督学习建立了经过连续临床，形态，血液动力学和所有数据训练的高风险预测因子，以及它们与AAA进化的联系。与临床数据相比，形态，血液动力学和所有数据的预测性能都很高。基于形态学的预测子表现出有趣的工作量-可预测性折衷，需要进行临床翻译验证。最后，通过监督学习建立了经过连续临床，形态，血液动力学和所有数据训练的高风险预测因子，以及它们与AAA进化的联系。与临床数据相比，形态，血液动力学和所有数据的预测性能都很高。基于形态学的预测子表现出有趣的工作量-可预测性折衷，需要进行临床翻译验证。