Service de Chirurgie Vasculaire, Hôpitaux Universitaires La Pitié-Salpêtrière, 47-83 Bd del'Hôpital, 75013, Paris, France; Sorbonne Université, UPMC UnivParis06, CNRS, UMR7190, Institut Jean Le Rond d'Alembert, 75005, Paris, France.
Universidad de Buenos Aires, Facultad de Medicina. Departamento de Ciencias Fisiológicas, Laboratorio de Biomembranas, Paraguay 2155, C1121 ABG, Buenos Aires, Argentina; CONICET-Universidad de Buenos Aires. Instituto de Fisiología y Biofísica Bernardo Houssay, Paraguay 2155, C1121 ABG, Buenos Aires, Argentina.
Comput Biol Med. 2019 Nov;114:103440. doi: 10.1016/j.compbiomed.2019.103440. Epub 2019 Sep 9.
The curvature of the aortic arch is associated with the risk of endoleak formation after thoracic endovascular aortic repair (TEVAR). However, the adequate assessment of the angles of the aorta continues to represent a major difficulty. We developed a new program based on three-dimensional (3D) reconstructions of computed tomography (CT) scans to objectively identify the location of the aortic points of maximum curvature, and to automatically calculate the main aortic arch angles, comparing final values with visual assessment methods.
This is a cross-sectional validation study of a convenience sample of subjects with multislice CT angiography scans of the thoracic aorta from an institutional imaging database. The center lumen line (CLL) of the aorta was determined semi-automatically using Endosize software. The points of maximum curvature on the CLL were determined by two methods: visually by two physicians and through a custom program.
The study enrolled 9 subjects: 4 with thoracic aneurysms and 5 with normal aortas. The inter-observer and inter-method correlation, agreement and reliability for each of the 3D spatial coordinates of the points of maximum curvature were appropriate. However, the aortic angles determined by visual assessment showed a very low to moderate correlation and reliability with those determined by our custom program.
An automated custom program can reflect clinician's intuitive assessment of the location of points of maximum curvature and translate it into aortic angles with an apparently higher precision, reducing potential error and user time.
主动脉弓的曲率与胸主动脉腔内修复术（TEVAR）后内漏形成的风险相关。然而，对主动脉角度的充分评估仍然是一个主要的难点。我们开发了一个新的程序，基于 CT 扫描的三维（3D）重建，以客观地确定主动脉最大弯曲点的位置，并自动计算主要主动脉弓角度，将最终值与视觉评估方法进行比较。
这是一项来自机构成像数据库的多排 CT 血管造影扫描的主动脉的横断面验证研究，采用方便抽样法。使用 Endosize 软件半自动确定主动脉的中心管腔线（CLL）。通过两种方法确定 CLL 上的最大弯曲点：由两名医生进行视觉判断和通过自定义程序。
该研究纳入了 9 名受试者：4 名患有胸主动脉瘤，5 名主动脉正常。最大弯曲点的 3D 空间坐标的每个观察者之间和方法之间的相关性、一致性和可靠性均适当。然而，通过视觉评估确定的主动脉角度与我们自定义程序确定的角度相关性和可靠性非常低到中度。
一个自动的自定义程序可以反映临床医生对最大弯曲点位置的直观评估，并将其转化为主动脉角度，具有明显更高的精度，减少潜在的误差和用户时间。
