A Dual-Functional System for the Classification and Diameter Measurement of Aortic Dissections Using CTA Volumes via Deep Learning

Acute aortic dissection is one of the most life-threatening cardiovascular diseases, with a high mortality rate. Its prevalence ranges from 0.2% to 0.8% in humans, resulting in a significant number of deaths due to being missed in manual examinations. More importantly, the aortic diameter—a critical indicator for surgical selection—significantly influences the outcomes of surgeries post-diagnosis. Therefore, it is an urgent yet challenging mission to develop an automatic aortic dissection diagnostic system that can recognize and classify the aortic dissection type and measure the aortic diameter. This paper offers a dual-functional deep learning system called DDAsys that enables both accurate classification of aortic dissection and precise diameter measurement of the aorta. To this end, we created a dataset containing 61 190 computed tomography angiography (CTA) images from 279 patients from the Division of Cardiothoracic and Vascular Surgery at Tongji Hospital, Wuhan, China. The dataset provides a slice-level summary of difficult-to-identify features, which helps to improve the accuracy of both recognition and classification. Our system achieves a recognition F1 score of 0.984, an average classification F1 score 0.937, and the respective measurement precisions for ascending and descending aortic diameters are 0.994 mm and 0.767 mm root mean square error (RMSE). The high consistency (88.6%) between the recommended surgical treatments and the actual corresponding surgeries verifies the capability of our system to aid clinicians in developing a more prompt, precise, and consistent treatment strategy.