Velu Juliëtte F, Groot Jebbink Erik, de Vries Jean-Paul Pm, van der Palen Job Am, Slump Cornelis H, Geelkerken Robert H
Department of Vascular Surgery, Medical Spectrum Twente, Enschede, the Netherlands.
MIRA Institute for Biomedical Engineering and Technical Medicine, University of Twente, Enschede, the Netherlands.
Vascular. 2018 Apr;26(2):198-202. doi: 10.1177/1708538117726648. Epub 2017 Aug 18.
Objectives Correct sizing of endoprostheses used for the treatment of abdominal aortic aneurysms is important to prevent endoleaks and migration. Sizing requires several steps and each step introduces a possible sizing error. The goal of this study was to investigate the magnitude of these errors compared to the golden standard: a vessel phantom. This study focuses on the errors in sizing with three different brands of computed tomography angiography scanners in combination with three reconstruction software packages. Methods Three phantoms with a different diameter, altitude and azimuth were scanned with three computed tomography scanners: Toshiba Aquilion 64-slice, Philips Brilliance iCT 256-slice and Siemens Somatom Sensation 64-slice. The phantom diameters were determined in the stretched view after central lumen line reconstruction by three observers using Simbionix PROcedure Rehearsal Studio, 3mensio and TeraRecon planning software. The observers, all novices in sizing endoprostheses using planning software, measured 108 slices each. Two senior vascular surgeons set the tolerated error margin of sizing on ±1.0 mm. Results In total, 11.3% of the measurements (73/648) were outside the set margins of ±1.0 mm from the phantom diameter, with significant differences between the scanner types (14.8%, 12.1%, 6.9% for the Siemens scanner, Philips scanner and Toshiba scanner, respectively, p-value = 0.032), but not between the software packages (8.3%, 11.1%, 14.4%, p-value = 0.141) or the observers (10.6%, 9.7%, 13.4%, p-value = 0.448). Conclusions It can be concluded that the errors in sizing were independent of the used software packages, but the phantoms scanned with Siemens scanner were significantly more measured incorrectly than the phantoms scanned with the Toshiba scanner. Consequently, awareness on the type of computed tomography scanner and computed tomography scanner setting is necessary, especially in complex abdominal aortic aneurysms sizing for fenestrated or branched endovascular aneurysm repair if appropriate the sizing is of upmost importance.
目的 正确确定用于治疗腹主动脉瘤的内置假体尺寸对于预防内漏和移位至关重要。尺寸确定需要几个步骤，且每个步骤都可能引入尺寸误差。本研究的目的是将这些误差的大小与金标准：血管模型进行比较。本研究聚焦于三种不同品牌的计算机断层扫描血管造影（CTA）扫描仪与三种重建软件包结合使用时的尺寸确定误差。方法 使用三台CTA扫描仪对三个直径、高度和方位不同的模型进行扫描：东芝Aquilion 64排、飞利浦Brilliance iCT 256排和西门子Somatom Sensation 64排。三位观察者使用Simbionix PROcedure Rehearsal Studio、3mensio和TeraRecon规划软件在重建中心腔线后的拉伸视图中确定模型直径。观察者均为使用规划软件确定内置假体尺寸的新手，每人测量108层。两名资深血管外科医生将尺寸确定的容许误差范围设定为±1.0毫米。结果 总体而言，11.3%的测量值（73/648）偏离模型直径±1.0毫米的设定范围，扫描仪类型之间存在显著差异（西门子扫描仪、飞利浦扫描仪和东芝扫描仪分别为14.8%、12.1%、6.9%，p值 = 0.032），但软件包之间（8.3%、11.1%、14.4%，p值 = 0.141）或观察者之间（10.6%、9.7%、13.4%，p值 = 0.448）不存在显著差异。结论 可以得出结论，尺寸确定误差与所使用的软件包无关，但使用西门子扫描仪扫描的模型比使用东芝扫描仪扫描的模型测量错误明显更多。因此，有必要了解CTA扫描仪的类型和CTA扫描仪设置，特别是在复杂腹主动脉瘤尺寸确定以进行开窗或分支型血管内动脉瘤修复时，合适的尺寸确定至关重要。
