1 Imaging Biomarkers and Computer-Aided Diagnosis Laboratory, Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bldg 10, Rm 1C224D MSC 1182, Bethesda, MD 20892-1182.
AJR Am J Roentgenol. 2014 Jan;202(1):W50-8. doi: 10.2214/AJR.12.10463.
The purpose of this study was to show the spatial relationship of the colonic marginal blood vessels and the teniae coli on CT colonography (CTC) and the use of the marginal blood vessels for supine-prone registration of polyps and for determination of proper connectivity of collapsed colonic segments.
We manually labeled the marginal blood vessels on 15 CTC examinations. Colon segmentation, centerline extraction, teniae detection, and teniae identification were automatically performed. For assessment of their spatial relationships, the distances from the marginal blood vessels to the three teniae coli and to the colon were measured. Student t tests (paired, two-tailed) were performed to evaluate the differences among these distances. To evaluate the reliability of the marginal vessels as reference points for polyp correlation, we analyzed 20 polyps from 20 additional patients who underwent supine and prone CTC. The average difference of the circumferential polyp position on the supine and prone scans was computed. Student t tests (paired, two-tailed) were performed to evaluate the supine-prone differences of the distance. We performed a study on 10 CTC studies from 10 patients with collapsed colonic segments by manually tracing the marginal blood vessels near the collapsed regions to resolve the ambiguity of the colon path.
The average distances (± SD) from the marginal blood vessels to the tenia mesocolica, tenia omentalis, and tenia libera were 20.1 ± 3.1 mm (95% CI, 18.5-21.6 mm), 39.5 ± 4.8 mm (37.1-42.0 mm), and 36.9 ± 4.2 mm (34.8-39.1 mm), respectively. Pairwise comparison showed that these distances to the tenia libera and tenia omentalis were significantly different from the distance to the tenia mesocolica (p < 0.001). The average distance from the marginal blood vessels to the colon wall was 15.3 ± 2.0 mm (14.2-16.3 mm). For polyp localization, the average difference of the circumferential polyp position on the supine and prone scans was 9.6 ± 9.4 mm (5.5-13.7 mm) (p = 0.15) and expressed as a percentage of the colon circumference was 3.1% ± 2.0% (2.3-4.0%) (p = 0.83). We were able to trace the marginal blood vessels for 10 collapsed colonic segments and determine the paths of the colon in these regions.
The marginal blood vessels run parallel to the colon in proximity to the tenia mesocolica and enable accurate supine-prone registration of polyps and localization of the colon path in areas of collapse. Thus, the marginal blood vessels may be used as reference landmarks complementary to the colon centerline and teniae coli.
本研究旨在展示结肠边缘血管和结肠带在 CT 结肠成像（CTC）中的空间关系，并利用边缘血管对息肉进行仰卧-俯卧配准，以及确定塌陷结肠段的适当连接。
我们手动标记了 15 例 CTC 检查中的边缘血管。自动进行结肠分段、中心线提取、结肠带检测和结肠带识别。为了评估它们的空间关系，测量了边缘血管到三条结肠带和结肠的距离。采用配对双侧 Student t 检验评估这些距离的差异。为了评估边缘血管作为息肉相关性参考点的可靠性，我们分析了另外 20 例接受仰卧和俯卧 CTC 检查的患者的 20 个息肉。计算仰卧和俯卧扫描中环周息肉位置的平均差异。采用配对双侧 Student t 检验评估距离的仰卧-俯卧差异。我们对 10 例 CTC 研究中的 10 例塌陷结肠段进行了研究，通过手动追踪塌陷区域附近的边缘血管来解决结肠路径的模糊性。
边缘血管到结肠系膜缘、大网膜缘和游离缘的平均距离（±SD）分别为 20.1±3.1mm（95%CI，18.5-21.6mm）、39.5±4.8mm（37.1-42.0mm）和 36.9±4.2mm（34.8-39.1mm）。两两比较显示，与结肠系膜缘相比，这些距离与游离缘和大网膜缘显著不同（p<0.001）。边缘血管到结肠壁的平均距离为 15.3±2.0mm（14.2-16.3mm）。对于息肉定位，仰卧和俯卧扫描中环周息肉位置的平均差异为 9.6±9.4mm（5.5-13.7mm）（p=0.15），以结肠周长的百分比表示为 3.1%±2.0%（2.3-4.0%）（p=0.83）。我们能够追踪 10 个塌陷的结肠段的边缘血管，并确定这些区域的结肠路径。
边缘血管在靠近结肠系膜缘的位置与结肠平行，能够实现息肉的精确仰卧-俯卧配准，并确定塌陷区域的结肠路径。因此，边缘血管可以作为补充结肠中心线和结肠带的参考标志物。
