Acute Aortic Syndrome

Purpose	Acute aortic syndromes (AAS), including acute aortic dissection are life-threatening emergencies affecting about 10,000 cases per year in the United States.
Tag(s)
Panel	Cardiac Panel
Define-AI ID	19040026
Originator	Paul Schoenhagen
Lead	Howard Chen
Panel Chair	Carlo De Cecco
Panel Reviewers	Cardiac Panel
License	Creative Commons 4.0
Status	Published

Clinical Implementation

Value Proposition

Acute aortic dissection has high early mortality with a death rate as high as 1% per hour during the first 24 hours. Automatic detection improves time-to-intervention and thereby improves mortality.

Narrative(s)

A patient arriving to ED with pleuric chest pain. Differential diagnosis is wide. The patient receives chest CT. Automation allows parallel triggering of the AAS management, and prioritization on the radiologist worklist for immediate review.

Workflow Description

The image is obtained from modality and sent to PACS and the AI engine. The image is analyzed by the engine. The system then detects probability of acute aortic syndrome. An alert message is sent to PACS from the engine with the information, identification, and graphic highlighting the features of the image that are most influential to the model prediction.

Considerations for Dataset Development

Aortic Dissection	{acute, subacute, chronic}
Ischemia	{abdominal organ ischemia, limb ischemia, ischemic or embolic stroke, paraplegia}
Comorbidities	{hypertension, inherited connective tissue disorder, atherosclerosis, vasculitis, coronary artery disease, chronic obstructive pulmonary disease}
Aortic emergencies	{Aortic dissection, aortic intramural hematoma, penetrating atherosclerotic ulcer, aortic aneurysmal rupture, traumatic thoracic aortic injury, traumatic abdominal aortic injury}
Smoking history	{Yes, No}
Aortic aneurysmal rupture	{Intraperitoneal rupture, retroperitoneal rupture, aortocaval fistula, primary aorto-enteric fistula}

Technical Specifications

Inputs

DICOM Study

Procedure	CT
Views	Axial, coronal, sagittal
Data Type	DICOM
Modality	CT
Body Region	Chest
Anatomic Focus	Heart

Primary Outputs

Acute aortic syndrome

RadElement ID	RDE825
Definition	Presence of acute aortic syndrome
Data Type	Categorical
Value Set	Acute aortic syndrome absent Acute aortic syndrome present Unknown
Units	N/A

Stanford classification

RadElement ID	RDE826
Definition	Classification of an acute aortic syndrome
Data Type	Categorical
Value Set	Stanford A Stanford B Unknown
Units	N/A

Future Development Ideas

Graphical overlay of the features that suggest acute aortic syndrome

Related Datasets

No known related public datasets at this time, please alert us if you know of any.