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      Vascular Deformation Mapping (VDM) of Thoracic Aortic Enlargement in Aneurysmal Disease and Dissection

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          Abstract

          Thoracic aortic aneurysm is a common and lethal disease that requires regular imaging surveillance to determine timing of surgical repair and prevent major complications such as rupture. Current cross-sectional imaging surveillance techniques, largely based on computed tomography angiography, are focused on measurement of maximal aortic diameter, although this approach is limited to fixed anatomic positions and is prone to significant measurement error. Here we present preliminary results showing the feasibility of a novel technique for assessing change in aortic dimensions, termed vascular deformation mapping (VDM). This technique allows quantification of 3-dimensional changes in the aortic wall geometry through nonrigid coregistration of computed tomography angiography images and spatial Jacobian analysis of aortic deformation. Through several illustrative cases we demonstrate that this method can be used to measure changes in the aortic wall geometry among patients with stable and enlarging thoracic aortic aneurysm and dissection. Furthermore, VDM results yield observations about the presence, distribution, and rate of aortic wall deformation that are not apparent by routine clinical evaluation. Finally, we show the feasibility of superposing patient-specific VDM results on a 3-dimensional aortic model using color 3D printing and discuss future directions and potential applications for the VDM technique.

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          Most cited references42

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          2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine.

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            CT-based Biomarker Provides Unique Signature for Diagnosis of COPD Phenotypes and Disease Progression

            Chronic obstructive pulmonary disease (COPD) is increasingly being recognized as a highly heterogeneous disorder, composed of varying pathobiology. Accurate detection of COPD subtypes by image biomarkers are urgently needed to enable individualized treatment thus improving patient outcome. We adapted the Parametric Response Map (PRM), a voxel-wise image analysis technique, for assessing COPD phenotype. We analyzed whole lung CT scans of 194 COPD individuals acquired at inspiration and expiration from the COPDGene Study. PRM identified the extent of functional small airways disease (fSAD) and emphysema as well as provided CT-based evidence that supports the concept that fSAD precedes emphysema with increasing COPD severity. PRM is a versatile imaging biomarker capable of diagnosing disease extent and phenotype, while providing detailed spatial information of disease distribution and location. PRMs ability to differentiate between specific COPD phenotypes will allow for more accurate diagnosis of individual patients complementing standard clinical techniques.
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              Regulatory T cells in cardiovascular diseases.

              Inflammation is essential in the initial development and progression of many cardiovascular diseases involving innate and adaptive immune responses. The role of CD4(+)CD25(+)FOXP3(+) regulatory T (TREG) cells in the modulation of inflammation and immunity has received increasing attention. Given the important role of TREG cells in the induction and maintenance of immune homeostasis and tolerance, dysregulation in the generation or function of TREG cells can trigger abnormal immune responses and lead to pathology. A wealth of evidence from experimental and clinical studies has indicated that TREG cells might have an important role in protecting against cardiovascular disease, in particular atherosclerosis and abdominal aortic aneurysm. In this Review, we provide an overview of the roles of TREG cells in the pathogenesis of a number of cardiovascular diseases, including atherosclerosis, hypertension, ischaemic stroke, abdominal aortic aneurysm, Kawasaki disease, pulmonary arterial hypertension, myocardial infarction and remodelling, postischaemic neovascularization, myocarditis and dilated cardiomyopathy, and heart failure. Although the exact molecular mechanisms underlying the cardioprotective effects of TREG cells are still to be elucidated, targeted therapies with TREG cells might provide a promising and novel future approach to the prevention and treatment of cardiovascular diseases.
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                Author and article information

                Journal
                101671170
                44558
                Tomography
                Tomography
                Tomography : a journal for imaging research
                2379-1381
                1 November 2017
                September 2017
                07 November 2017
                : 3
                : 3
                : 163-173
                Affiliations
                [1 ]Department of Radiology, University of Michigan, Ann Arbor, MI
                [2 ]Center for Molecular Imaging, University of Michigan, Ann Arbor, MI
                [3 ]Department of Biological Chemistry, University of Michigan, Ann Arbor, MI
                Author notes
                Corresponding Author: Nicholas Burris, MD, Department of Radiology, University of Michigan, 1500 E. Medical Center Drive, TC B1-132, SPC-5030, Ann Arbor, MI 48109-5030; nburris@ 123456med.umich.edu
                Article
                NIHMS908145
                10.18383/j.tom.2017.00015
                5675573
                bee9fe84-284f-4934-be95-5c2983802273

                This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/).

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                Categories
                Article

                aortic aneurysm,spatial jacobian,aortic dissection,3d printing,aneurysmal enlargement,vascular deformation mapping

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