Aortic distensibility imaging

Aortic distensibility cine imaging captures cyclic ascending and descending aortic area change. CardiacNexus uses this modality for the pressure-normalized stiffness subset of Aortic stiffness and distensibility.

Modality
Aortic distensibility cine CMR
UKB source
Data Field 20210
Pipeline step
Ascending/descending aorta segmentation QC, area/diameter extraction, pressure-gated distensibility calculation, and aortic area visualization
Outputs
aortic_dist.csv, visualization/aorta/aortic_area.png, timeseries/aortic_area.png
Maturity
Source-audited modality page

Current pipeline role

The current source expects aortic_dist.nii.gz and seg_aortic_dist.nii.gz, where label 1 is ascending aorta and label 2 is descending aorta. It applies aorta_pass_quality_control, computes per-frame areas, derives equivalent maximum/mean/minimum diameters and maximum/mean/minimum areas, and writes the structural rows before attempting pressure-normalized distensibility.

Distensibility requires a configured pressure table and central pulse pressure column. Central pulse pressure below 10 mmHg is treated as invalid, and distensibility values above the current high-value threshold are skipped.

Current outputs

Output familyCurrent rowsSource pathNotes
Equivalent diametersascending and descending maximum, mean, and minimum diameter rowssrc/feature_extraction/Aortic_Distensibility_20210/eval_aortic_dist.pyequivalent diameter from area; legacy Maxium spelling is preserved
Aortic areasascending and descending maximum, mean, and minimum area rowseval_aortic_dist.pyderived from label area and pixel spacing
Distensibilityascending and descending pressure-normalized distensibility rowseval_aortic_dist.py; configured pressure fileconditional on valid pressure and threshold checks
QC and time seriesvisualization/aorta/aortic_area.png, timeseries/aortic_area.pngeval_aortic_dist.pyshows max/min area frames and area curves

Pressure denominator matters

Area change and distensibility are not interchangeable. Distensibility normalizes cyclic area change by central pulse pressure, so missing or invalid pressure data make pressure-normalized rows unavailable.

QC and interpretation caveats

The modality is sensitive to aortic segmentation quality, label consistency, cardiac phase sampling, pressure source configuration, and high-value filtering. Diameter rows are equivalent diameters derived from segmented area rather than direct caliper measurements.

Aortic distensibility cine values should not be silently combined with scout centerline geometry or LVOT root diameters. Each acquisition answers a different vascular question and carries different measurement assumptions.

Source audit

  • Current input names, label meanings, QC call, area/diameter formulas, pressure gating, high-value skip behavior, output labels, and visualization paths were checked against eval_aortic_dist.py.
  • docs/data/output_column_inventory.yml records the aortic_dist artifact contract.
  • Textbook context boundary: broad clinical textbook context is not surfaced here because implementation and vascular stiffness literature context in the phenotype page are sufficient for draft rollout.
PWV methods schematic used as a stiffness-method boundary for aortic distensibility imaging
PWV methods schematic from the manuscript image cache, cited there to Westenberg et al. 2012, shown only as a stiffness-method boundary. CardiacNexus aortic-distensibility imaging currently emits local area, diameter, and pressure-normalized distensibility rows, not PWV.Source: manuscript image cache citing Westenberg et al. 2012; permission and exact source-panel review pending for draft use.
  • Displayed figure provenance is recorded in docs/data/figure_provenance.yml; permission and exact reuse wording remain pending for public release. A current-output local area/diameter curve remains the preferred replacement for public-release readiness.