Garzon-Mancera Nicolas D, Khasiyev Farid, Del Brutto Victor J, Spagnolo Allende Antonio J, Wright Clinton B, Elkind Mitchell, Rundek Tatjana, Del Brutto Oscar H, Gutierrez Jose
Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA.
Department of Neurology, St. Louis University Hospital, St. Louis, Missouri, USA.
J Neuroimaging. 2024 Sep-Oct;34(5):588-594. doi: 10.1111/jon.13217. Epub 2024 May 29.
Brain arterial luminal diameters are reliably measured with automated imaging software. Nonautomated imaging software alternatives such as a Picture Archiving Communication System are more common bedside tools used for manual measurement. This study is aimed at validating manual measurements against automated methods.
We randomly selected 600 participants from the Northern Manhattan Study (NOMAS) and 260 participants from the Atahualpa Project studied with 1.5 Tesla MR angiography. Using the Radiant measuring tool, three independent readers (general practitioner, neurology resident, and vascular neurologist) measured manually the diameter of arterial brain vessels. The same vessels were also measured by LKEB Automated Vessel Analysis (LAVA). We calculated the intraclass correlation coefficient (ICC) of each rater's diameters versus those obtained with LAVA.
The ICC between diameters obtained by the general practitioner or the neurology resident compared to LAVA was excellent for both internal carotid arteries (ICA) and Basilar Arteries (BA) (ICC > .80 in all comparisons) in NOMAS. In the Atahualpa Project, ICC between diameters obtained by a vascular neurologist and LAVA was good for both ICA and BA (ICC > .60 in all comparisons). The ICCs for the measurements of the remaining arteries were moderate to poor.
Results suggest that manual measurements of ICA and BA diameters, but not MCA or ACA, are valid and could be used to identify dilated brain arteries at the bedside and for eventual selection of patients with dolichoectasia into clinical trials.
脑动脉管腔直径可通过自动成像软件可靠测量。诸如图像存档与通信系统等非自动成像软件是更常用的床边手动测量工具。本研究旨在验证手动测量相对于自动测量方法的准确性。
我们从北曼哈顿研究（NOMAS）中随机选取600名参与者，从阿塔瓦尔帕项目中随机选取260名参与者，这些参与者均接受了1.5特斯拉磁共振血管造影检查。使用Radiant测量工具，三名独立的阅片者（全科医生、神经科住院医师和血管神经科医生）手动测量脑动脉血管的直径。同样的血管也通过LKEB自动血管分析（LAVA）进行测量。我们计算了每个阅片者测量的直径与LAVA测量结果之间的组内相关系数（ICC）。
在NOMAS中，全科医生或神经科住院医师测量的直径与LAVA测量结果之间的ICC，对于颈内动脉（ICA）和基底动脉（BA）均表现出色（所有比较中ICC>.80）。在阿塔瓦尔帕项目中，血管神经科医生测量的直径与LAVA测量结果之间的ICC，对于ICA和BA均良好（所有比较中ICC>.60）。其余动脉测量的ICC为中等至较差。
结果表明，手动测量ICA和BA的直径是有效的，但测量大脑中动脉（MCA）或大脑前动脉（ACA）则不然，可用于在床边识别扩张的脑动脉，并最终筛选出患有动脉迂曲扩张症的患者进入临床试验。
