Changes in Aortic Diameter and Wall Strain in Progressing Abdominal Aortic Aneurysms

Objectives The analysis of wall strain opens new perspectives in the prediction of abdominal aortic aneurysm (AAA) rupture. This study investigates the capability of four‐dimensional ultrasound (4D US) to detect and characterize changes in wall strain in the same patients during follow‐up observations. Methods Eighteen patients were examined by 64 4D US scans during a median follow‐up period of 24.5 months. After performing the 4D US and manual aneurysm segmentation, kinematic analysis was performed using a customized interface and evaluation of the mean and peak circumferential strain, as well as spatial heterogeneity. Results All aneurysms showed a continuous diameter growth with a mean rate of 4% per year (P