Accuracy and Variability of Semiautomatic Centerline Analysis versus Manual Aortic Measurement Techniques for TEVAR
Accuracy and Variability of Semiautomatic Centerline Analysis versus Manual Aortic Measurement Techniques for TEVAR
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DOI：
10.1016/j.ejvs.2012.12.003
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发表时间：
2013-03-01
影响因子：
5.7
通讯作者：
von Tengg-Kobligk, H.
中科院分区：
文献类型：
--
作者：
Mueller-Eschner, M.;Rengier, F.;von Tengg-Kobligk, H.
目的：本研究旨在检验与人工评估相比，半自动中心线分析是否能改善胸血管内主动脉修复（TEVAR）直径测量的观察者间变异性和时间。方法：由2位血管放射学盲法专家对30例胸主动脉病变患者（平均年龄66.8±11.6岁，男性23例）术前CT血管造影结果进行回顾性分析。使用手动轴向切片（axial）、手动双斜多平面重构（MPRs）和半自动中心线分析三种测量技术评估与TEVAR相关的三个位置（P1，左侧颈总动脉远端；P2，左侧锁骨下动脉远端；P3，乳糜干近端）的最大主动脉直径。结果：中心线分析和轴向技术测量的直径与MPR没有显著差异（p = 0.17和p = 0.37）。总偏差指数为0.9的P1为2.7 mm（轴向）、3.7 mm （MPR）、1.8 mm（中心线）；用于P2 2.0 mm（轴向）、3.6 mm （MPR）、1.8 mm（中心线）；P3为3.0 mm（轴向）、3.5 mm （MPR）、2.5 mm（中心线）。中心线法测定时间明显短于MPR法测定时间。结论：中心线分析为TEVAR患者提供了最小变量和快速的直径测量，与当前参考标准MPR具有相同的准确性。(C) 2012年欧洲血管外科学会。Elsevier Ltd.出版。版权所有。
Objectives: This study aims to test whether inter-observer variability and time of diameter measurements for thoracic endovascular aortic repair (TEVAR) are improved by semiautomatic centerline analysis compared to manual assessment.Methods: Preoperative computed tomography (CT) angiographies of 30 patients with thoracic aortic disease (mean age 66.8 +/- 11.6 years, 23 males) were retrospectively analysed by two blinded experts in vascular radiology. Maximum aortic diameters at three positions relevant to TEVAR were assessed (P1, distal to left common carotid artery; P2, distal to left subclavian artery; and P3, proximal to coeliac trunk) using three measurement techniques: manual axial slices (axial), manual double-oblique multiplanar reformations (MPRs) and semiautomatic centerline analysis.Results: Diameter measurements by both centerline analysis and the axial technique did not significantly differ from MPR (p = 0.17 and p = 0.37). Total deviation index for 0.9 was for P1 2.7 mm (axial), 3.7 mm (MPR), 1.8 mm (centerline); for P2 2.0 mm (axial), 3.6 mm (MPR), 1.8 mm (centerline); and for P3 3.0 mm (axial), 3.5 mm (MPR), 2.5 mm (centerline). Measurement time using centerline analysis was significantly shorter than for assessment by MPR.Conclusions: Centerline analysis provides the least variable and fast diameter measurements in TEVAR patients with the same accuracy as the current reference standard MPR. (C) 2012 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.