{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T21:37:19Z","timestamp":1777844239610,"version":"3.51.4"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T00:00:00Z","timestamp":1664496000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>We attempted to measure maximum transverse diameter (MTD) of and CT values of ILT by using multi-spiral computed tomography angiography (MSCTA) to investigate the predictive value of MTD with different CT values of thrombus on the risk of AAA rupture.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty-five intact abdominal aortic aneurysms (IAAA) and 17 ruptured abdominal aortic aneurysms (RAAA) were included in this study. MTD and CT values in their planes were measured from MSCTA images and aneurysm lumen and thrombus volumes were calculated for the range of different CT values.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median of maximum CT value of thrombus at the plane of MTD was higher in RAAA (107.0 HU) than the median in IAAA (84.5 HU) (<jats:italic>P<\/jats:italic> &amp;lt; 0.001). Univariate logistic regression analysis showed that the maximum CT value was a risk factor for RAAA (<jats:italic>P<\/jats:italic> &amp;lt; 0.001). It was further found that the area under the ROC curve for thrombus maximum CT value in the MTD plane to predict RAAA was 0.848 (<jats:italic>P<\/jats:italic> &amp;lt; 0.001), with a cut-off value of 97.5 HU, a sensitivity of 82.35%, and a specificity of 84.44%. And the MTD of the abnormal lumen combined with the maximum CT value at its plane predicted RAAA with an area under the ROC curve of 0.901, a sensitivity of 76.47%, and a specificity of 97.78%. The further analysis of thrombus volume in the range of different CT value showed that median thrombus volume in RAAA in the range of 30 HU~150 HU was 124.2 cm<jats:sup>3<\/jats:sup> which was higher than the median of 81.4 cm<jats:sup>3<\/jats:sup> in IAAA (<jats:italic>P<\/jats:italic> = 0.005). To exclude confounding factors (aneurysm volume), we calculated the standardized thrombus (ILT volume\/total aneurysm volume), and the thrombus volume in the range of 30 HU~150 HU in RAAA was positively correlated with the standardized thrombus volume (\u03c1 = 0.885, <jats:italic>P<\/jats:italic> &amp;lt; 0.001), while the thrombus volume in the range of \u2212100 HU~30 HU was not correlated with it (\u03c1 = 0.309, <jats:italic>P<\/jats:italic> = 0.228).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>High-density ILT shown on MSCTA in AAAs is associated with aneurysm rupture, and its maximum transverse diameter combined with the maximum CT value in its plane is a better predictor of RAAA.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2022.951264","type":"journal-article","created":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T06:12:30Z","timestamp":1664518350000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["High-density thrombus and maximum transverse diameter on multi-spiral computed tomography angiography combine to predict abdominal aortic aneurysm rupture"],"prefix":"10.3389","volume":"9","author":[{"given":"Heqian","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhipeng","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haijian","family":"Fan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoli","family":"Mai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Cai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tong","family":"Qiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,9,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1165","DOI":"10.1016\/j.jvs.2008.01.055","article-title":"Expanding use of emergency endovascular repair for ruptured abdominal aortic aneurysms: disparities in outcomes from a nationwide perspective","volume":"47","author":"Lesperance","year":"2008","journal-title":"J Vasc Surg"},{"key":"B2","unstructured":"Risk factors associated with abdominal aortic aneurysm growth or rupture\n            NICEEvidence Reviews Collection [M]\n          32407036LondonNational Institute for Health and Care Excellence (NICE)Abdominal Aortic Aneurysm: Diagnosis and Management2020"},{"key":"B3","doi-asserted-by":"publisher","first-page":"943","DOI":"10.1093\/qjmed\/hcu086","article-title":"Ruptured emphysematous infectious aortitis after endoprothesis placement","volume":"107","author":"Yen","year":"2014","journal-title":"QJM."},{"key":"B4","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1016\/j.ejvs.2010.09.011","article-title":"Management of abdominal aortic aneurysms clinical practice guidelines of the European society for vascular surgery","volume":"41","author":"Moll","year":"2011","journal-title":"Eur J Vasc Endovasc Surg."},{"key":"B5","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1002\/bjs.6779","article-title":"Growth rates of small abdominal aortic aneurysms correlate with clinical events","volume":"97","author":"Thompson","year":"2010","journal-title":"Br J Surg."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1445","DOI":"10.1056\/NEJMoa013527","article-title":"Long-term outcomes of immediate repair compared with surveillance of small abdominal aortic aneurysms","volume":"346","author":"Powell","year":"2002","journal-title":"N Engl J Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1437","DOI":"10.1056\/NEJMoa012573","article-title":"Immediate repair compared with surveillance of small abdominal aortic aneurysms","volume":"346","author":"Lederle","year":"2002","journal-title":"N Engl J Med."},{"key":"B8","doi-asserted-by":"publisher","first-page":"054503","DOI":"10.1115\/1.4033082","article-title":"Geodesics-based surface parameterization to assess aneurysm progression","volume":"138","author":"Phan","year":"2016","journal-title":"J Biomech Eng."},{"key":"B9","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1016\/j.jvs.2012.10.097","article-title":"Current state of experimental imaging modalities for risk assessment of abdominal aortic aneurysm","volume":"57","author":"Buijs","year":"2013","journal-title":"J Vasc Surg."},{"key":"B10","first-page":"67","article-title":"Effect of thrombus on abdominal aortic aneurysm wall dilation and stress","volume":"44","author":"Thubrikar","year":"2003","journal-title":"J Cardiovasc Surg (Torino)."},{"key":"B11","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1067\/mva.2002.126087","article-title":"Effect of intraluminal thrombus on wall stress in patient-specific models of abdominal aortic aneurysm","volume":"36","author":"Wang","year":"2002","journal-title":"J Vasc Surg."},{"key":"B12","doi-asserted-by":"publisher","first-page":"921","DOI":"10.1007\/s10439-008-9490-3","article-title":"The effects of anisotropy on the stress analyses of patient-specific abdominal aortic aneurysms","volume":"36","author":"Vande Geest","year":"2008","journal-title":"Ann Biomed Eng."},{"key":"B13","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1016\/j.avsg.2011.08.015","article-title":"Intraluminal thrombus has a selective influence on matrix metalloproteinases and their inhibitors (tissue inhibitors of matrix metalloproteinases) in the wall of abdominal aortic aneurysms","volume":"26","author":"Khan","year":"2012","journal-title":"Ann Vasc Surg."},{"key":"B14","doi-asserted-by":"publisher","first-page":"9","DOI":"10.2310\/6670.2006.00008","article-title":"Intraluminal thrombus enhances proteolysis in abdominal aortic aneurysms","volume":"14","author":"Carrell","year":"2006","journal-title":"Vascular."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1283","DOI":"10.1016\/S0741-5214(03)00791-2","article-title":"Influence of intraluminal thrombus on structural and cellular composition of abdominal aortic aneurysm wall","volume":"38","author":"Kazi","year":"2003","journal-title":"J Vasc Surg."},{"key":"B16","doi-asserted-by":"publisher","first-page":"e007562","DOI":"10.1161\/CIRCIMAGING.117.007562","article-title":"Quantification of coronary atherosclerosis in the assessment of coronary artery disease","volume":"11","author":"Lee","year":"2018","journal-title":"Circ Cardiovasc Imaging."},{"key":"B17","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1016\/j.neurad.2019.03.009","article-title":"Carotid artery imaging: The study of intra-plaque vascularization and hemorrhage in the era of the \u201cvulnerable\u201d plaque","volume":"47","author":"Porcu","year":"2020","journal-title":"J Neuroradiol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1557","DOI":"10.1016\/j.jvs.2020.09.026","article-title":"Low-density vulnerable thrombus\/plaque volume on preoperative computed tomography predicts for spinal cord ischemia after endovascular repair for thoracic aortic aneurysm","volume":"73","author":"Banno","year":"2021","journal-title":"J Vasc Surg"},{"key":"B19","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.jacc.2009.02.068","article-title":"Computed tomographic angiography characteristics of atherosclerotic plaques subsequently resulting in acute coronary syndrome","volume":"54","author":"Motoyama","year":"2009","journal-title":"J Am Coll Cardiol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1007\/s10237-010-0191-0","article-title":"Impact of calcifications on patient-specific wall stress analysis of abdominal aortic aneurysms","volume":"9","author":"Maier","year":"2010","journal-title":"Biomech Model Mechanobiol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1430","DOI":"10.1016\/j.jbiomech.2014.01.041","article-title":"The biaxial mechanical behaviour of abdominal aortic aneurysm intraluminal thrombus: classification of morphology and the determination of layer and region specific properties","volume":"47","author":"O'Leary","year":"2014","journal-title":"J Biomech."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1577","DOI":"10.1016\/S0140-6736(05)66459-8","article-title":"Abdominal aortic aneurysm","volume":"365","author":"Sakalihasan","year":"2005","journal-title":"Lancet."},{"key":"B23","doi-asserted-by":"publisher","first-page":"239","DOI":"10.3109\/03091902.2015.1040173","article-title":"Wall stress in media layer of stented three-layered aortic aneurysm at different intraluminal thrombus locations with pulsatile heart cycle","volume":"39","author":"Rahmani","year":"2015","journal-title":"J Med Eng Technol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"2253","DOI":"10.1007\/s10439-015-1267-x","article-title":"On the impact of intraluminal thrombus mechanical behavior in AAA passive mechanics","volume":"43","author":"Riveros","year":"2015","journal-title":"Ann Biomed Eng."},{"key":"B25","doi-asserted-by":"publisher","first-page":"39","DOI":"10.23736\/S0392-9590.18.04006-3","article-title":"Effect of intraluminal thrombus on growth rate of abdominal aortic aneurysms","volume":"38","author":"Domonkos","year":"2019","journal-title":"Int Angiol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.jvs.2012.07.003","article-title":"Intraluminal abdominal aortic aneurysm thrombus is associated with disruption of wall integrity","volume":"57","author":"Koole","year":"2013","journal-title":"J Vasc Surg."},{"key":"B27","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1016\/S1078-5884(96)80002-5","article-title":"Pathogenesis of abdominal aortic aneurysms\u2013cellular and biochemical mechanisms","volume":"12","author":"Wills","year":"1996","journal-title":"Eur J Vasc Endovasc Surg."},{"key":"B28","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1053\/ejvs.2000.1217","article-title":"Growth of thrombus may be a better predictor of rupture than diameter in patients with abdominal aortic aneurysms","volume":"20","author":"Stenbaek","year":"2000","journal-title":"Eur J Vasc Endovasc Surg."},{"key":"B29","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1016\/j.jvs.2017.08.069","article-title":"Intraluminal thrombus is associated with early rupture of abdominal aortic aneurysm","volume":"67","author":"Haller","year":"2018","journal-title":"J Vasc Surg"},{"key":"B30","doi-asserted-by":"publisher","first-page":"2511","DOI":"10.1016\/j.jacc.2018.02.079","article-title":"Coronary atherosclerotic precursors of acute coronary syndromes","volume":"71","author":"Chang","year":"2018","journal-title":"J Am Coll Cardiol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.atherosclerosis.2020.05.017","article-title":"Calcium deposition within coronary atherosclerotic lesion: Implications for plaque stability","volume":"306","author":"Jinnouchi","year":"2020","journal-title":"Atherosclerosis."},{"key":"B32","doi-asserted-by":"publisher","first-page":"666","DOI":"10.1038\/s41569-021-00552-1","article-title":"Interplay between inflammation and thrombosis in cardiovascular pathology","volume":"18","author":"Stark","year":"2021","journal-title":"Nat Rev Cardiol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"1108","DOI":"10.1016\/j.jvs.2008.06.063","article-title":"Bleeding into the intraluminal thrombus in abdominal aortic aneurysms is associated with rupture","volume":"48","author":"Roy","year":"2008","journal-title":"J Vasc Surg."},{"key":"B34","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1016\/j.jvs.2005.01.004","article-title":"Size and location of thrombus in intact and ruptured abdominal aortic aneurysms","volume":"41","author":"Hans","year":"2005","journal-title":"J Vasc Surg."},{"key":"B35","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1016\/j.jvir.2017.07.028","article-title":"Localized hyperattenuations in the intraluminal thrombus may predict rupture of abdominal aortic aneurysms","volume":"29","author":"Talvitie","year":"2018","journal-title":"J Vasc Interv Radiol."},{"key":"B36","doi-asserted-by":"publisher","first-page":"2447","DOI":"10.3892\/mmr.2016.4825","article-title":"Effects of different shear rates on the attachment and detachment of platelet thrombi","volume":"13","author":"Shi","year":"2016","journal-title":"Mol Med Rep."},{"key":"B37","doi-asserted-by":"publisher","first-page":"14430","DOI":"10.1073\/pnas.1322917111","article-title":"Platelet mechanosensing of substrate stiffness during clot formation mediates adhesion, spreading, and activation","volume":"111","author":"Qiu","year":"2014","journal-title":"Proc Natl Acad Sci U S A."},{"key":"B38","doi-asserted-by":"publisher","first-page":"532","DOI":"10.1016\/j.thromres.2013.12.037","article-title":"The platelet and the biophysical microenvironment: lessons from cellular mechanics","volume":"133","author":"Ciciliano","year":"2014","journal-title":"Thromb Res."},{"key":"B39","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1067\/mva.2001.114813","article-title":"Association of intraluminal thrombus in abdominal aortic aneurysm with local hypoxia and wall weakening","volume":"34","author":"Vorp","year":"2001","journal-title":"J Vasc Surg."},{"key":"B40","doi-asserted-by":"publisher","first-page":"2065","DOI":"10.1016\/j.jvs.2019.03.057","article-title":"Systematic review and meta-analysis of the association between intraluminal thrombus volume and abdominal aortic aneurysm rupture","volume":"70","author":"Singh","year":"2019","journal-title":"J Vasc Surg"},{"key":"B41","doi-asserted-by":"publisher","first-page":"2619","DOI":"10.1182\/blood-2017-08-743237","article-title":"Antithrombotic therapy in abdominal aortic aneurysm: beneficial or detrimental?","volume":"132","author":"Cameron","year":"2018","journal-title":"Blood."}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2022.951264\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T06:12:35Z","timestamp":1664518355000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2022.951264\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,30]]},"references-count":41,"alternative-id":["10.3389\/fcvm.2022.951264"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2022.951264","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,30]]},"article-number":"951264"}}