Hammon Matthias, Rompel Oliver, Seuss Hannes, Dittrich Sven, Uder Michael, Rüffer Andrè, Cesnjevar Robert, Ehret Nicole, Glöckler Martin
Department of Radiology, University Hospital Erlangen, Friedrich Alexander Universität (FAU) Erlangen-Nürnberg, Maximiliansplatz 1, 91054, Erlangen, Germany.
Department of Pediatric Cardiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuernberg, Loschgestrasse 15, 91054, Erlangen, Germany.
Pediatr Cardiol. 2017 Dec;38(8):1540-1547. doi: 10.1007/s00246-017-1693-7. Epub 2017 Jul 31.
Computed tomography (CT)-angiography is routinely performed prior to catheter-based and surgical treatment in congenital heart disease. To date, little is known about the accuracy and advantage of different 3D-reconstructions in CT-data. Exact anatomical information is crucial. We analyzed 35 consecutive CT-angiographies of infants with congenital heart disease. All datasets are reconstructed three-dimensionally using volume rendering technique (VRT) and threshold-based segmentation (stereolithographic model, STL). Additionally, the two-dimensional maximum intensity projection (MIP) reconstructs two-dimensional data. In each dataset and resulting image, measurements of vascular diameters for four different vessels were estimated and compared to the reference standard, measured via multiplanar reformation (MPR). The resulting measurements obtained via the STL-images, MIP-images, and the VRT-images were compared with the reference standard. There was a significant difference (p < 0.05) between measurements. The mean difference was 0.0 for STL-images, -0.1 for MIP-images, and -0.3 for VRT-images. The range of the differences was -0.7 to 1.0 mm for STL-images, -0.6 to 0.5 mm for MIP-images and -1.1 to 0.7 mm for VRT-images. There was an excellent correlation between the STL-, MIP-, VRT-measurements, and the reference standard. Inter-reader reliability was excellent (p < 0.01). STL-models of cardiovascular structures are more accurate than the traditional VRT-models. Additionally, they can be standardized and are reproducible.
在先天性心脏病的导管介入治疗和手术治疗之前，通常会进行计算机断层扫描（CT）血管造影。迄今为止，对于CT数据中不同三维重建的准确性和优势了解甚少。精确的解剖学信息至关重要。我们分析了35例先天性心脏病婴儿的连续CT血管造影。所有数据集均使用容积再现技术（VRT）和基于阈值的分割（立体光刻模型，STL）进行三维重建。此外，二维最大密度投影（MIP）用于重建二维数据。在每个数据集和所得图像中，估计四条不同血管的血管直径测量值，并与通过多平面重建（MPR）测量的参考标准进行比较。将通过STL图像、MIP图像和VRT图像获得的测量结果与参考标准进行比较。测量结果之间存在显著差异（p < 0.05）。STL图像的平均差异为0.0，MIP图像为 -0.1，VRT图像为 -0.3。STL图像的差异范围为 -0.7至1.0毫米，MIP图像为 -0.6至0.5毫米，VRT图像为 -1.1至0.7毫米。STL、MIP、VRT测量值与参考标准之间具有极好的相关性。不同阅片者之间的可靠性极佳（p < 0.01）。心血管结构的STL模型比传统的VRT模型更准确。此外，它们可以标准化且具有可重复性。
