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Anatomically realistic aortic dissection simulator as a potential training tool for point-of-care ultrasound

Mutiah Rahmah
Mutiah Rahmah
, 
Rania Hussien Al-Ashwal
Rania Hussien Al-Ashwal
, 
Maheza Irna Mohamad Salim
Maheza Irna Mohamad Salim
, 
Yan Tung Lam
Yan Tung Lam
 and 
Yuan Wen Hau
Yuan Wen Hau
   | Feb 27, 2024
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Article Category: Research paper
Published Online: Feb 27, 2024
Page range: -
Received: Apr 18, 2023
Accepted: Aug 23, 2023
DOI: https://doi.org/10.15557/jou.2024.0002
Keywords
© 2024 Mutiah Rahmah et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1.

Final design of the mould in Cura software after the slicing process; the hours indicate the time estimation for completing the printing process and the weight mass (g) for the required filament. A. 3D design of the healthy aorta mould. B. 3D design of the aortic dissection mould
Final design of the mould in Cura software after the slicing process; the hours indicate the time estimation for completing the printing process and the weight mass (g) for the required filament. A. 3D design of the healthy aorta mould. B. 3D design of the aortic dissection mould

Fig. 2.

Synthesised simulator based on PVA. A. Healthy aorta simulator from top view B. Ascending aorta of the healthy aorta (point of interest) C. Aortic dissection simulator from top view D. Ascending aortic dissection (point of interest)
Synthesised simulator based on PVA. A. Healthy aorta simulator from top view B. Ascending aorta of the healthy aorta (point of interest) C. Aortic dissection simulator from top view D. Ascending aortic dissection (point of interest)

Fig. 3.

Synthesised simulator based on silicone. A. Healthy aorta simulator from top view B. Ascending aorta of the healthy aorta (point of interest) C. Aortic dissection simulator from top view D. Ascending aortic dissection (point of interest)
Synthesised simulator based on silicone. A. Healthy aorta simulator from top view B. Ascending aorta of the healthy aorta (point of interest) C. Aortic dissection simulator from top view D. Ascending aortic dissection (point of interest)

Fig. 4.

Low-fidelity simulators immersed in agarose A. Healthy aorta (left), aortic dissection synthesised from PVA (right); B. Healthy aorta (left), aortic dissection synthesised from silicone (right)
Low-fidelity simulators immersed in agarose A. Healthy aorta (left), aortic dissection synthesised from PVA (right); B. Healthy aorta (left), aortic dissection synthesised from silicone (right)

Root mean square (RMS) value obtained from (Rq) in imageJ between the healthy aorta (AAo) and AD simulator synthesised from PVA and silicone

Root Mean Square (RMS) PVA Silicone Actual aorta
Healthy aorta (AAo) 10.26 23.07 13.11
Aortic dissection (AD) 20.28 33.8 38.83

3D surface plot of SEM images analysed with imageJ between the healthy AAo and AD simulator (PVA and silicone) and the actual aorta

Simulator synthesised by PVA Simulator synthesised by silicone Actual aorta
Healthy AAo
Aortic dissection

Average grey value of the intimal flap (μIF) and echogenicity index of false lumen (EIFL) obtained from imageJ of AD simulator ultrasound image between PVA and silicone

Simulator Healthy aorta
Average Grey Value (μIF) Echogenicity Index (EIFL)
PVA 170.89 85.27
Silicone 99.36 77.84
p<0.05

Surface texture morphology of PVA and silicone simulators in SEM test (healthy AAo and AD compared to the actual aorta)

Simulator synthesised by PVA Simulator synthesised by silicone Actual aorta(17,24)
Healthy aorta
Aortic dissection

Surface plot of grey value in each pixel obtained by imageJ between the healthy AAo and aortic dissection, compared by simulators and the actual aorta

PVA (healthy AAo) PVA (aortic dissection) Si (healthy AAo) Si (aortic dissection) Actual (healthy AAo) Actual (aortic dissection)
Min 40.46 41.78 58.23 60.18 92.89 64.35
Max 52.01 59.62 66.78 91.54 98.23 109.59
σ 2.04 5.35 2.14 9.59 0.92 13.68
σ2 4.16 28.57 4.56 91.97 0.84 187.36

Ultrasound images of the healthy aorta and aortic dissection simulators (PVA and silicone) and the actual aorta (comparison of short-axis and longitudinal views)

Short-axis view Longitudinal view
Healthy aorta of PVA
Healthy aorta of silicone
Aortic dissection of PVA
Aortic dissection of silicone
Actual aortic dissection image(25)
Notes

In the short-axis view, the diameter of the aorta is indicated by the letters A and B, while its thickness by the letter C.

The arrow marks the intimal flap in the AD images.

In the long-axis view, the healthy aorta images show the ascending aorta in its normal condition with no flap, whereas the AD indicated by the arrow shows the presence of the flap.
eISSN:
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Language:
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Journal Subjects:
Medicine, Basic Medical Science, other
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