The aortic vessel tree is composed of the aorta and its branching arteries, and plays a key role in supplying the whole body with blood. Aortic diseases, like aneurysms or dissections, can lead to an aortic rupture, whose treatment with open surgery is highly risky. Therefore, patients commonly undergo drug treatment under constant monitoring, which requires regular inspections of the vessels through imaging. The standard imaging modality for diagnosis and monitoring is computed tomography (CT), which can provide a detailed picture of the aorta and its branching vessels if completed with a contrast agent, called CT angiography (CTA). Optimally, the whole aortic vessel tree geometry from consecutive CTAs is overlaid and compared. This allows not only detection of changes in the aorta, but also of its branches, caused by the primary pathology or newly developed. When performed manually, this reconstruction requires slice by slice contouring, which could easily take a whole day for a single aortic vessel tree, and is therefore not feasible in clinical practice. Automatic or semi-automatic vessel tree segmentation algorithms, however, can complete this task in a fraction of the manual execution time and run in parallel to the clinical routine of the clinicians. In this paper, we systematically review computing techniques for the automatic and semi-automatic segmentation of the aortic vessel tree. The review concludes with an in-depth discussion on how close these state-of-the-art approaches are to an application in clinical practice and how active this research field is, taking into account the number of publications, datasets and challenges.

翻译：主动脉血管树由主动脉及其分支动脉组成，在向全身供血中起关键作用。主动脉疾病（如动脉瘤或夹层）可能导致主动脉破裂，而采用开腹手术治疗风险极高。因此，患者通常在接受持续性监测的同时进行药物治疗，这需要通过影像学定期检查血管。诊断和监测的标准成像方式是计算机断层扫描（CT），若配合造影剂使用（称为CT血管造影，CTA），则可清晰显示主动脉及其分支血管的详细结构。理想情况下，需将多次连续CTA扫描获取的完整主动脉血管树几何结构进行重叠比较。这不仅能检测由原发病理或新发病灶引起的主动脉变化，还能观察其分支动脉的变化。若通过手动操作，这种重建需逐层勾画轮廓，单个主动脉血管树就可能耗费整整一天时间，因此在临床实践中不可行。而自动或半自动血管树分割算法可在手动操作所需时间的一小部分内完成此任务，并能与临床医生的日常工作并行进行。本文系统综述了用于主动脉血管树自动与半自动分割的计算技术。最后，结合相关论文数量、数据集及竞赛情况，深入探讨这些前沿方法距离临床实践应用还有多远，以及该研究领域的活跃程度。