Abstract：
UNASSIGNED: In current practice, the diameter of an aortic aneurysm is utilized to estimate the rupture risk and decide upon timing of elective repair, although it is known to be imprecise and not patient-specific. Quantitative magnetic resonance imaging (MRI) enables the visualization of several biomarkers that provide information about processes within the aneurysm and may therefore facilitate patient-specific risk stratification. We performed a scoping review of the literature on quantitative MRI techniques to assess aortic aneurysm progression and rupture risk, summarized these findings, and identified knowledge gaps.
UNASSIGNED: Literature concerning primary research was of interest and the medical databases PubMed, Scopus, Embase, and Cochrane were systematically searched. This study used the PRISMA protocol extension for scoping reviews. Articles published between January 2010 and February 2023 involving animals and/or humans were included. Data were extracted by 2 authors using a predefined charting method.
UNASSIGNED: A total of 1641 articles were identified, of which 21 were included in the scoping review. Quantitative MRI-derived biomarkers were categorized into hemodynamic (8 studies), wall (5 studies) and molecular biomarkers (8 studies). Fifteen studies included patients and/or healthy human subjects. Animal models were investigated in the other 6 studies. A cross-sectional study design was the most common, whereas 5 animal studies had a longitudinal component and 2 studies including patients had a prospective design. A promising hemodynamic biomarker is wall shear stress (WSS), which is estimated based on 4D-flow MRI. Molecular biomarkers enable the assessment of inflammatory and wall deterioration processes. The ADAMTS4-specific molecular magnetic resonance (MR) probe showed potential to predict abdominal aortic aneurysm (AAA) formation and rupture in a murine model. Wall biomarkers assessed using dynamic contrast-enhanced (DCE) MRI showed great potential for assessing AAA progression independent of the maximum diameter.
UNASSIGNED: This scoping review provides an overview of quantitative MRI techniques studied and the biomarkers derived from them to assess aortic aneurysm progression and rupture risk. Longitudinal studies are needed to validate the causal relationships between the identified biomarkers and aneurysm growth, rupture, or repair. In the future, quantitative MRI could play an important role in the personalized risk assessment of aortic aneurysm rupture.
CONCLUSIONS: The currently used maximum aneurysm diameter fails to accurately assess the multifactorial pathology of an aortic aneurysm and precisely predicts rupture in a patient-specific manner. Quantitative magnetic resonance imaging (MRI) enables the detection of various quantitative parameters involved in aneurysm progression and subsequent rupture. This scoping review provides an overview of the studied quantitative MRI techniques, the biomarkers derived from them, and recommendations for future research needed for the implementation of these biomarkers. Ultimately, quantitative MRI could facilitate personalized risk assessment for patients with aortic aneurysms, thereby reducing untimely repairs and improving rupture prevention.
UNASSIGNED: Literature concerning primary research was of interest and the medical databases PubMed, Scopus, Embase, and Cochrane were systematically searched. This study used the PRISMA protocol extension for scoping reviews. Articles published between January 2010 and February 2023 involving animals and/or humans were included. Data were extracted by 2 authors using a predefined charting method.
UNASSIGNED: A total of 1641 articles were identified, of which 21 were included in the scoping review. Quantitative MRI-derived biomarkers were categorized into hemodynamic (8 studies), wall (5 studies) and molecular biomarkers (8 studies). Fifteen studies included patients and/or healthy human subjects. Animal models were investigated in the other 6 studies. A cross-sectional study design was the most common, whereas 5 animal studies had a longitudinal component and 2 studies including patients had a prospective design. A promising hemodynamic biomarker is wall shear stress (WSS), which is estimated based on 4D-flow MRI. Molecular biomarkers enable the assessment of inflammatory and wall deterioration processes. The ADAMTS4-specific molecular magnetic resonance (MR) probe showed potential to predict abdominal aortic aneurysm (AAA) formation and rupture in a murine model. Wall biomarkers assessed using dynamic contrast-enhanced (DCE) MRI showed great potential for assessing AAA progression independent of the maximum diameter.
UNASSIGNED: This scoping review provides an overview of quantitative MRI techniques studied and the biomarkers derived from them to assess aortic aneurysm progression and rupture risk. Longitudinal studies are needed to validate the causal relationships between the identified biomarkers and aneurysm growth, rupture, or repair. In the future, quantitative MRI could play an important role in the personalized risk assessment of aortic aneurysm rupture.
CONCLUSIONS: The currently used maximum aneurysm diameter fails to accurately assess the multifactorial pathology of an aortic aneurysm and precisely predicts rupture in a patient-specific manner. Quantitative magnetic resonance imaging (MRI) enables the detection of various quantitative parameters involved in aneurysm progression and subsequent rupture. This scoping review provides an overview of the studied quantitative MRI techniques, the biomarkers derived from them, and recommendations for future research needed for the implementation of these biomarkers. Ultimately, quantitative MRI could facilitate personalized risk assessment for patients with aortic aneurysms, thereby reducing untimely repairs and improving rupture prevention.
摘要：
■在目前的实践中，主动脉瘤的直径用于估计破裂风险并决定选择性修复的时机，尽管已知它不精确且不是患者特异性的。定量磁共振成像（MRI）能够可视化几种生物标志物，这些生物标志物提供了有关动脉瘤内过程的信息，因此可以促进患者特定的风险分层。我们对定量MRI技术的文献进行了范围审查，以评估主动脉瘤的进展和破裂风险。总结了这些发现，并确定了知识差距。
■有关主要研究的文献引起了人们的兴趣，医学数据库PubMed，Scopus,Embase,对Cochrane进行了系统的搜索.本研究使用PRISMA协议扩展进行范围审查。包括2010年1月至2023年2月之间发表的涉及动物和/或人类的文章。数据由2位作者使用预定义的图表方法提取。
■共识别出1641篇文章，其中21人被纳入范围审查。定量MRI衍生的生物标志物分为血液动力学（8项研究），壁（5项研究）和分子生物标志物（8项研究）。15项研究包括患者和/或健康人受试者。在其他6项研究中研究了动物模型。横断面研究设计是最常见的，而5项动物研究具有纵向成分,2项包括患者在内的研究具有前瞻性设计.一个有前途的血液动力学生物标志物是壁剪切应力（WSS），这是根据4D流MRI估算的。分子生物标记物能够评估炎症和壁恶化过程。ADAMTS4特异性分子磁共振（MR）探针显示出在小鼠模型中预测腹主动脉瘤（AAA）形成和破裂的潜力。使用动态对比增强（DCE）MRI评估的壁生物标志物显示出评估AAA进展的巨大潜力，而与最大直径无关。
■本范围审查概述了所研究的定量MRI技术以及从其衍生的生物标志物，以评估主动脉瘤的进展和破裂风险。需要进行纵向研究以验证已识别的生物标志物与动脉瘤生长之间的因果关系。破裂,或修理。在未来,定量MRI可在主动脉瘤破裂的个性化风险评估中发挥重要作用。
结论：目前使用的最大动脉瘤直径无法准确评估主动脉瘤的多因素病理，也无法以患者特异性方式准确预测破裂。定量磁共振成像(MRI)能够检测涉及动脉瘤进展和随后破裂的各种定量参数。本范围审查概述了所研究的定量MRI技术，从它们衍生的生物标志物，以及实施这些生物标志物所需的未来研究建议。最终,定量MRI可以促进主动脉瘤患者的个性化风险评估，从而减少不及时的修理和提高防止破裂。
■有关主要研究的文献引起了人们的兴趣，医学数据库PubMed，Scopus,Embase,对Cochrane进行了系统的搜索.本研究使用PRISMA协议扩展进行范围审查。包括2010年1月至2023年2月之间发表的涉及动物和/或人类的文章。数据由2位作者使用预定义的图表方法提取。
■共识别出1641篇文章，其中21人被纳入范围审查。定量MRI衍生的生物标志物分为血液动力学（8项研究），壁（5项研究）和分子生物标志物（8项研究）。15项研究包括患者和/或健康人受试者。在其他6项研究中研究了动物模型。横断面研究设计是最常见的，而5项动物研究具有纵向成分,2项包括患者在内的研究具有前瞻性设计.一个有前途的血液动力学生物标志物是壁剪切应力（WSS），这是根据4D流MRI估算的。分子生物标记物能够评估炎症和壁恶化过程。ADAMTS4特异性分子磁共振（MR）探针显示出在小鼠模型中预测腹主动脉瘤（AAA）形成和破裂的潜力。使用动态对比增强（DCE）MRI评估的壁生物标志物显示出评估AAA进展的巨大潜力，而与最大直径无关。
■本范围审查概述了所研究的定量MRI技术以及从其衍生的生物标志物，以评估主动脉瘤的进展和破裂风险。需要进行纵向研究以验证已识别的生物标志物与动脉瘤生长之间的因果关系。破裂,或修理。在未来,定量MRI可在主动脉瘤破裂的个性化风险评估中发挥重要作用。
结论：目前使用的最大动脉瘤直径无法准确评估主动脉瘤的多因素病理，也无法以患者特异性方式准确预测破裂。定量磁共振成像(MRI)能够检测涉及动脉瘤进展和随后破裂的各种定量参数。本范围审查概述了所研究的定量MRI技术，从它们衍生的生物标志物，以及实施这些生物标志物所需的未来研究建议。最终,定量MRI可以促进主动脉瘤患者的个性化风险评估，从而减少不及时的修理和提高防止破裂。
