Aortic length measurements for pulse wave velocity calculation: manual 2D vs automated 3D centreline extraction.
Aortic length measurements for pulse wave velocity calculation: manual 2D vs automated 3D centreline extraction.
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DOI：
10.1186/s12968-017-0341-y
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发表时间：
2017-03-08
期刊：
影响因子：
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通讯作者：
Alastruey J
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文献类型：
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作者：
van Engelen A;Silva Vieira M;Rafiq I;Cecelja M;Schneider T;de Bliek H;Figueroa CA;Hussain T;Botnar RM;Alastruey J
脉搏波速度（PWV）是主动脉壁固有硬度的生物标志物，并已被证明可预测心血管事件。可以使用心血管磁共振（CMR）从主动脉中两个或多个位置处的相位对比流波形之间的延迟以及这些位置之间的CMR图像上的距离进行评估。本研究旨在探讨不同距离测量方法对PWV的影响。我们提出并评估了一种算法，用于自动中心线跟踪的3D图像，并比较PWV计算使用的距离来自3D图像从传统的2D的主动脉矢状面图像。我们纳入了来自双胞胎队列的35例患者和20例缩窄修复术后患者。在升主动脉、降主动脉和主动脉瘤中获得相位对比血流。提出了一种3D中心线跟踪算法，并在30名受试者的一个子集上进行了评价，采用三种CMR序列：平衡稳态自由进动（SSFP）、黑血双反转恢复快速自旋回波和对比增强CMR血管造影。随后比较2D冠状-矢状面和3D几何结构的测量值之间的主动脉长度。与手动注释相比，自动3D中心线跟踪的长度误差范围为2.4 [1.8-4.3] mm（平均值[IQR]，黑血）至6.4 [4.7-8.9] mm（SSFP）。对PWV的影响小于0.5m/s（<5%）。对于我们的大多数实验，2D和3D中心线长度之间的差异是显著的（p < 0.05）。PWV的个体差异大于0.5米/秒的所有情况下，15%（胸主动脉）和37%时，研究主动脉弓。最后，舒张末期和收缩末期2D中心线长度之间的差异具有统计学意义（p < 0.01），但PWV差异较小（0.08 [0.04 - 0.10]m/s）。三种常用CMR序列中的自动主动脉中心线跟踪具有良好的准确性。根据主动脉曲率、主动脉矢状面的适当规划以及采集之间的患者运动，从此类序列获得的3D长度可能与从2D主动脉矢状面获得的长度有很大不同。为了准确测量PWV，我们建议使用3D中心线。
Pulse wave velocity (PWV) is a biomarker for the intrinsic stiffness of the aortic wall, and has been shown to be predictive for cardiovascular events. It can be assessed using cardiovascular magnetic resonance (CMR) from the delay between phase-contrast flow waveforms at two or more locations in the aorta, and the distance on CMR images between those locations. This study aimed to investigate the impact of different distance measurement methods on PWV. We present and evaluate an algorithm for automated centreline tracking in 3D images, and compare PWV calculations using distances derived from 3D images to those obtained from a conventional 2D oblique-sagittal image of the aorta. We included 35 patients from a twin cohort, and 20 post-coarctation repair patients. Phase-contrast flow was acquired in the ascending, descending and diaphragmatic aorta. A 3D centreline tracking algorithm is presented and evaluated on a subset of 30 subjects, on three CMR sequences: balanced steady-state free precession (SSFP), black-blood double inversion recovery turbo spin echo, and contrast-enhanced CMR angiography. Aortic lengths are subsequently compared between measurements from a 2D oblique-sagittal plane, and a 3D geometry. The error in length of automated 3D centreline tracking compared with manual annotations ranged from 2.4 [1.8-4.3] mm (mean [IQR], black-blood) to 6.4 [4.7-8.9] mm (SSFP). The impact on PWV was below 0.5m/s (<5%). Differences between 2D and 3D centreline length were significant for the majority of our experiments (p < 0.05). Individual differences in PWV were larger than 0.5m/s in 15% of all cases (thoracic aorta) and 37% when studying the aortic arch only. Finally, the difference between end-diastolic and end-systolic 2D centreline lengths was statistically significant (p < 0.01), but resulted in small differences in PWV (0.08 [0.04 - 0.10]m/s). Automatic aortic centreline tracking in three commonly used CMR sequences is possible with good accuracy. The 3D length obtained from such sequences can differ considerably from lengths obtained from a 2D oblique-sagittal plane, depending on aortic curvature, adequate planning of the oblique-sagittal plane, and patient motion between acquisitions. For accurate PWV measurements we recommend using 3D centrelines.