Department of Radiology, Radio-Oncology and Nuclear Medicine, University of Montreal, 2900 Édouard-Montpetit, Montreal, Quebec, Canada H3T 1J4.
Department of Radiology, Radio-Oncology and Nuclear Medicine, University of Montreal, 2900 Édouard-Montpetit, Montreal, Quebec, Canada H3T 1J4; Laboratoire Central du Traitement de l'Image, Research Imaging Platform, University of Montreal Hospital Research Center, Montreal, Canada.
J Vasc Interv Radiol. 2019 Apr;30(4):523-530. doi: 10.1016/j.jvir.2018.11.006.
To compare automated measurements of maximal diameter (D) of abdominal aortic aneurysm (AAA) orthogonal to luminal or outer wall envelope centerline for endovascular repair (EVAR) follow-up.
Eighty-three consecutive patients with AAA treated by EVAR who had at least 1 computed tomography (CT) scan before and 2 CT scans after EVAR with at least 5 months' interval were included. Three-dimensional reconstruction of the AAA was achieved with dedicated segmentation software. Performances of automated calculation algorithms of D perpendicular to lumen or outer wall envelope centerlines were then compared to manual measurement of D on double-oblique multiplanar reconstruction (gold standard). Accuracy of automated D measurements at baseline, follow-up, and progression over time was evaluated by calculation of mean error, Bland-Altman plot, and regression models.
Disagreement in D measurements between outer wall envelope algorithm and manual method was insignificant (mean error: baseline, -0.07 ± 1.66 mm, P = .7; first follow-up, 0.24 ± 1.69 mm, P = .2; last follow-up, -0.41 ± 2.74 mm, P = .17); whereas significant discrepancies were found between the luminal algorithm and the manual method (mean error: baseline, -1.24 ± 2.01 mm, P < .01; first follow-up, -1.49 ± 3.30 mm, P < .01; last follow-up, -1.78 ± 3.60 mm, P < .01). D progression results were more accurate with AAA outer wall envelope algorithm compared to luminal method (P = .2).
AAA outer wall envelope segmentation is recommended to enable automated calculation of D perpendicular to its centerline during EVAR follow-up.
比较用于血管内修复（EVAR）随访的腹主动脉瘤（AAA）正交于管腔或外壁包络中心线的最大直径（D）的自动测量。
纳入了 83 例连续接受 EVAR 治疗的 AAA 患者，这些患者在 EVAR 之前至少有 1 次 CT 扫描，在 EVAR 之后至少有 2 次 CT 扫描，两次 CT 扫描之间的间隔至少为 5 个月。使用专用分割软件对 AAA 进行三维重建。然后将管腔或外壁包络中心线垂直的 D 的自动计算算法的性能与双斜多平面重建（金标准）上的 D 手动测量进行比较。通过计算平均误差、Bland-Altman 图和回归模型，评估自动 D 测量在基线、随访和随时间进展的准确性。
外壁包络算法与手动方法在 D 测量上的差异无统计学意义（平均误差：基线，-0.07 ± 1.66 mm，P =.7；第一次随访，0.24 ± 1.69 mm，P =.2；最后一次随访，-0.41 ± 2.74 mm，P =.17）；而管腔算法与手动方法之间存在显著差异（平均误差：基线，-1.24 ± 2.01 mm，P <.01；第一次随访，-1.49 ± 3.30 mm，P <.01；最后一次随访，-1.78 ± 3.60 mm，P <.01）。与管腔方法相比，AAA 外壁包络算法的 D 进展结果更准确（P =.2）。
建议使用 AAA 外壁包络分割来实现 EVAR 随访期间垂直于其中心线的 D 的自动计算。
