Aortic dissection is a life-threatening cardiovascular disease characterized by blood entering the media layer of the aortic vessel wall. This creates a second flow channel, known as the false lumen, which weakens the aortic wall and can potentially lead to fatal aortic rupture. Current risk stratification of aortic dissections is primarily based on morphological features of the aorta. However, hemodynamics also play a significant role in disease progression, though their investigation and visualization remain challenging. Common flow visualizations often experience visual clutter, especially when dealing with the intricate morphologies of aortic dissections. In this work, we implement and evaluate different approaches to visualizing the flow in aortic dissections effectively. We employ three techniques, namely streaklines with depth-dependent halos, transparent streaklines, and smoke surfaces. The latter is a technique based on streak surfaces, enhanced with opacity modulations, to produce a smoke-like appearance that improves visual clarity. We adapt the original opacity modulation of smoke surfaces to visualize flow even within the complex geometries of aortic dissections, thereby enhancing visual fidelity. To effectively capture dissection hemodynamics, we developed customized seeding structures that adapt to the shape of the surrounding lumen. Our evaluation, conducted via an online questionnaire, included medical professionals, fluid simulation experts, and visualization specialists. By analyzing results across these groups, we highlight differences in preference and interpretability, offering insight into domain-specific needs. No single visualization technique emerged as the best overall. Smoke surfaces provide the best overall clarity and visual realism. However, participants found streaklines with halos to be the best for quantifying flow, dispite them introducing significant visual clutter. Transparent streaklines serve as a middle ground, offering improved clarity over halos while maintaining some level of detail. Across all participant groups, smoke surfaces were rated as the most visually appealing and lifelike, with medical professionals highlighting their resemblance to contrast-agent injections used in clinical practice.

Aortic dissection is a rare disease affecting the aortic wall layers splitting the aortic lumen into two flow channels: the true and false lumen. The rarity of the disease leads to a sparsity of available datasets resulting in a low amount of available training data for in-silico studies or the training of machine learning algorithms . To mitigate this issue, we use statistical shape modeling to create a database of Stanford type B dissection surface meshes. We account for the complex disease anatomy by modeling two separate flow channels in the aorta, the true and false lumen. Former approaches mainly modeled the aortic arch including its branches but not two separate flow channels inside the aorta. To our knowledge, our approach is the first to attempt generating synthetic aortic dissection surface meshes. For the statistical shape model, the aorta is parameterized using the centerlines of the respective lumen and the according ellipses describing the cross-section of the lumen while being aligned along the centerline employing rotation-minimizing frames. To evaluate our approach we introduce disease-specific quality criteria by investigating the torsion and twist of the true lumen.

Aortic dissection is a life-threatening cardiovascular disease constituted by the delamination of the aortic wall. Due to the weakened structure of the false lumen, the aorta often dilates over time, which can – after certain diameter thresholds are reached – increase the risk of fatal aortic rupture. The identification of patients with a high risk of late adverse events is an ongoing clinical challenge, further complicated by the complex dissection anatomy and the wide variety among patients. Moreover, patient-specific risk stratification depends not only on morphological, but also on hemodynamic factors, which can be derived from computer simulations or 4D flow magnetic resonance imaging (MRI). However, comprehensible visualizations that depict the complex anatomical and functional information in a single view are yet to be developed. These visualization tools will assist clinical research and decision-making by facilitating a comprehensive understanding of the aortic state. For that purpose, we identified several visualization tasks and requirements in close collaboration with cardiovascular imaging scientists and radiologists. We displayed true and false lumen hemodynamics using pathlines as well as surface hemodynamics on the dissection flap and the inner vessel wall. Pathlines indicate antegrade and retrograde flow, blood flow through fenestrations, and branch vessel supply. Dissection-specific hemodynamic measures, such as interluminal pressure difference and flap compliance, provide further insight of the blood flow throughout the cardiac cycle. Finally, we evaluated our visualization techniques with cardiothoracic and vascular surgeons in two separate virtual sessions. • Correct mapping of flow in true and false lumen, preventing incorrect integration. • Display of dissection flap deformation, compliance, and interluminal pressure difference. • Display of the impacts of blood flow dynamics on the weakened false lumen outer wall. • Display of luminal drainage patterns through the encoding of blood stream origins.

Abstract Aortic dissection is a life‐threatening vascular disease characterized by abrupt formation of a new flow channel (false lumen) within the aortic wall. Survivors of the acute phase remain at high risk for late complications, such as aneurysm formation, rupture, and death. Morphologic features of aortic dissection determine not only treatment strategies in the acute phase (surgical vs. endovascular vs. medical), but also modulate the hemodynamics in the false lumen, ultimately responsible for late complications. Accurate description of the true and false lumen, any communications across the dissection membrane separating the two lumina, and blood supply from each lumen to aortic branch vessels is critical for risk prediction. Patient‐specific surface representations are also a prerequisite for hemodynamic simulations, but currently require time‐consuming manual segmentation of CT data. We present an aortic dissection cross‐sectional model that captures the varying aortic anatomy, allowing for reliable measurements and creation of high‐quality surface representations. In contrast to the traditional spline‐based cross‐sectional model, we employ elliptic Fourier descriptors, which allows users to control the accuracy of the cross‐sectional contour of a flow channel. We demonstrate (i) how our approach can solve the requirements for generating surface and wall representations of the flow channels, (ii) how any number of communications between flow channels can be specified in a consistent manner, and (iii) how well branches connected to the respective flow channels are handled. Finally, we discuss how our approach is a step forward to an automated generation of surface models for aortic dissections from raw 3D imaging segmentation masks.

Temporal data visualization is used to analyze dependent variables that vary over time, with time being an independent variable. Visualizing temporal data is inherently difficult, due to the many aspects that need to be communicated to the users (e.g., time and variable changes). This is an important topic in visualization, and a wide range of visualization techniques dealing with different tasks have already been designed. In this paper we propose popup-plots, a novel concept where the common interaction of 3D rotation is used to navigate through the data. This allows the users to view the data from different perspectives without having to learn and adapt to new interaction concepts. Popup-plots are therefore a novel method for visualizing and interacting with dependent variables over time. We extend 2D plots with the temporal information by bending the space according to the time. The bending is calculated based on a spherical coordinates approach, which is continuously influenced by the viewing direction towards the plot. Hence, the plot can be viewed from various angles with seamless transitions in between, offering the possibility to analyze different aspects of the represented data. As the current viewing direction is inherently depicted by the shape of the data, the users are able to deduce which part of the data is currently viewed. The temporal information is encoded into the visualization itself, resembling annual rings of a tree. We demonstrate our method by applying it to data from two different domains, comprising measurements at spatial positions over time, and we also evaluated the usability of our solution.

Visualization of vascular structures is a common and frequently performed task in the field of medical imaging. There exist well established and applicable methods such as Maximum Intensity Projection (MIP) and Curved Planar Reformation (CPR). However, when calcified vessel walls are investigated, occlusion hinders exploration of the vessel interior with MIP. In contrast, CPR offers the possibility to visualize the vessel lumen by cutting a single vessel along its centerline. Extending the idea of CPR, we propose a novel technique, called Centerline Reformation (CR), which is capable of visualizing the lumen of spatially arbitrarily oriented vessels not necessarily connected in a tree structure. In order to visually emphasize depth, overlap and occlusion, halos can optionally envelope the vessel lumen. The required vessel centerlines are obtained from volumetric data by performing a scale-space based feature extraction. We present the application of the proposed technique in a focus and context setup. Further, we demonstrate how it facilitates the investigation of dense vascular structures, particularly cervical vessels or vessel data featuring peripheral arterial occlusive diseases or pulmonary embolisms. Finally, feedback from domain experts is given.

Accurate estimation of vessel parameters is a prerequisite for automated visualization and analysis of healthy and diseased blood vessels. The objective of this research is to estimate the dimensions of lower extremity arteries, imaged by computed tomography (CT). These parameters are required to get a good quality visualization of healthy as well as diseased arteries using a visualization technique such as curved planar reformation (CPR). The vessel is modeled using an elliptical or cylindrical structure with specific dimensions, orientation and blood vessel mean density. The model separates two homogeneous regions: its inner side represents a region of density for vessels, and its outer side a region for background. Taking into account the point spread function (PSF) of a CT scanner, a function is modeled with a Gaussian kernel, in order to smooth the vessel boundary in the model. A new strategy for vessel parameter estimation is presented. It stems from vessel model and model parameter optimization by a nonlinear optimization procedure, i.e., the Levenberg-Marquardt technique. The method provides center location, diameter and orientation of the vessel as well as blood and background mean density values. The method is tested on synthetic data and real patient data with encouraging results.

Accurate and reliable visualization of blood vessels is still a challenging problem, notably in the presence of morphologic changes resulting from atherosclerotic diseases. We take advantage of partially segmented data with approximately identified vessel centerlines to comprehensively visualize the diseased peripheral arterial tree. We introduce the VesselGlyph as an abstract notation for novel focus & context visualization techniques of tubular structures such as contrast-medium enhanced arteries in CT-angiography (CTA). The proposed techniques combine direct volume rendering (DVR) and curved planar reformation (CPR) within a single image. The VesselGlyph consists of several regions where different rendering methods are used. The region type, the used visualization method and the region parameters depend on the distance from the vessel centerline and on viewing parameters as well. By selecting proper rendering techniques for different regions, vessels are depicted in a naturally looking and undistorted anatomic context. This may facilitate the diagnosis and treatment planning of patients with peripheral arterial occlusive disease. In this paper we furthermore present a way of how to implement the proposed techniques in software and by means of modern 3D graphics accelerators.

Traditional volume visualization techniques may provide incomplete clinical information needed for applications in medical visualization. In the area of vascular visualization important features such as the lumen of a diseased vessel segment may not be visible. Curved planar reformation (CPR) has proven to be an acceptable practical solution. Existing CPR techniques, however, still have diagnostically relevant limitations. In this paper, we introduce two advances methods for efficient vessel visualization, based on the concept of CPR. Both methods benefit from relaxation of spatial coherence in favor of improved feature perception. We present a new technique to visualize the interior of a vessel in a single image. A vessel is resampled along a spiral around its central axis. The helical spiral depicts the vessel volume. Furthermore, a method to display an entire vascular tree without mutually occluding vessels is presented. Minimal rotations at the bifurcations avoid occlusions. For each viewing direction the entire vessel structure is visible.

Visualization of tubular structures such as blood vessels is an important topic in medical imaging. One way to display tubular structures for diagnostic purposes is to generate longitudinal cross-sections in order to show their lumen, wall, and surrounding tissue in a curved plane. This process is called curved planar reformation (CPR). We present three different methods to generate CPR images. A tube-phantom was scanned with computed tomography (CT) to illustrate the properties of the different CPR methods. Furthermore we introduce enhancements to these methods: thick-CPR, rotating-CPR and multi-path-CPR.

We report on using computed tomography (CT) as a model acquisition tool for complex objects in computer graphics. Unlike other modeling and scanning techniques the complexity of the object is irrelevant in CT, which naturally enables to model objects with, for example, concavities, holes, twists or fine surface details. Once the data is scanned, one can apply post-processing techniques for data enhancement, modification or presentation. For demonstration purposes we chose to scan a Christmas tree which exhibits high complexity which is difficult or even impossible to handle with other techniques. However, care has to be taken to achieve good scanning results with CT. Further, we illustrate post-processing by means of data segmentation and photorealistic as well as non-photorealistic surface and volume rendering techniques.

This paper deals with vessel exploration based on computed tomography angiography. Large image sequences of the lower extremities are investigated in a clinical environment. Two different approaches for peripheral vessel diagnosis dealing with stenosis and calcification detection are introduced. The paper presents an automated vessel-tracking tool for curved planar reformation. An interactive segmentation tool for bone removal is proposed.