The aortic vessel tree is composed of the aorta and its branching arteries, and plays a key role in supplying the whole body with blood. Aortic diseases, like aneurysms or dissections, can lead to an aortic rupture, whose treatment with open surgery is highly risky. Therefore, patients commonly undergo drug treatment under constant monitoring, which requires regular inspections of the vessels through imaging. The standard imaging modality for diagnosis and monitoring is computed tomography (CT), which can provide a detailed picture of the aorta and its branching vessels if combined with a contrast agent, resulting in a CT angiography (CTA). Optimally, the whole aortic vessel tree geometry from consecutive CTAs, are overlaid and compared. This allows to not only detect changes in the aorta, but also more peripheral vessel tree changes, caused by the primary pathology or newly developed. When performed manually, this reconstruction requires slice by slice contouring, which could easily take a whole day for a single aortic vessel tree and, hence, is not feasible in clinical practice. Automatic or semi-automatic vessel tree segmentation algorithms, on the other hand, can complete this task in a fraction of the manual execution time and run in parallel to the clinical routine of the clinicians. In this paper, we systematically review computing techniques for the automatic and semi-automatic segmentation of the aortic vessel tree. The review concludes with an in-depth discussion on how close these state-of-the-art approaches are to an application in clinical practice and how active this research field is, taking into account the number of publications, datasets and challenges.

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基于 AI 的主动脉血管树分割用于心血管疾病治疗：现状

主动脉血管树由主动脉及其分支动脉组成，对全身供血起着关键作用。主动脉疾病，如动脉瘤或夹层，可导致主动脉破裂，开放手术治疗其风险很高。因此，患者通常在持续监测下接受药物治疗，这需要通过成像定期检查血管。诊断和监测的标准成像方式是计算机断层扫描 (CT)，如果与造影剂结合，可以提供主动脉及其分支血管的详细图像，从而进行 CT 血管造影 (CTA)。最理想的是，来自连续 CTA 的整个主动脉血管树几何形状被叠加和比较。这不仅可以检测主动脉的变化，还可以检测更多的外围血管树变化，由原发病理引起或新发。当手动执行时，这种重建需要逐个切片轮廓绘制，这对于单个主动脉血管树来说很容易花费一整天的时间，因此在临床实践中是不可行的。另一方面，自动或半自动血管树分割算法可以在手动执行时间的一小部分内完成此任务，并与临床医生的临床程序并行运行。在本文中，我们系统地回顾了主动脉血管树自动和半自动分割的计算技术。综述最后深入讨论了这些最先进的方法与临床实践应用的接近程度以及该研究领域的活跃程度，同时考虑了出版物、数据集和挑战的数量。