Lalka S G, Stockberger S M, Johnson M S, Hawes D, Aisen A, Trerotola S O
Department of Surgery, Indiana University Medical Center, Indianapolis 46202, USA.
J Vasc Interv Radiol. 1998 Sep-Oct;9(5):799-807. doi: 10.1016/s1051-0443(98)70395-1.
Successful deployment of an endoluminal prosthesis for repair of an abdominal aortic aneurysm (AAA) is critically dependent on accurate preoperative assessment of aneurysm morphology with use of such modalities as contrast aortography (CA), spiral computed tomography (CT), magnetic resonance (MR) imaging, and intravascular ultrasonography (IVUWS). The authors describe a new phantom that could be used both to calibrate these four imaging modalities and to determine which imaging technique(s) is (are) best for preoperative AAA sizing.
A life-sized AAA model was constructed of silicone elastomers with luminal access ports for introduction of contrast media and catheters. Contrast material-filled rings were positioned circumferentially along the length of the model as reference points for dimension measurements. The modalities were compared to each other relative to the actual dimensions of the model, as determined at its construction.
In this pilot study, all modalities were relatively similar in their ability to measure the dimensions of the AAA model. Length measurements accounted for most of the interinstitutional and interobserver variability. MR imaging had the least variability.
The authors developed a new phantom that can be imaged successfully with CA, CT, MR imaging, and IVUS in repetitive, reproducible fashion. Structural refinements and future larger scale, statistically significant evaluations of such models should establish this as a useful adjunct in multicenter endoluminal stent-graft trials to allow calibration of imaging modalities and to determine which modality or modalities is (are) best for preoperative AAA sizing.
成功植入腔内假体修复腹主动脉瘤(AAA)严重依赖于使用诸如主动脉造影(CA)、螺旋计算机断层扫描(CT)、磁共振(MR)成像和血管内超声检查(IVUWS)等方式对动脉瘤形态进行准确的术前评估。作者描述了一种新的模型,其可用于校准这四种成像方式,并确定哪种成像技术最适合术前AAA尺寸测量。
用硅酮弹性体制备一个真人大小的AAA模型,带有用于引入造影剂和导管的腔内入口。沿模型长度方向周向放置充满造影剂的环作为尺寸测量的参考点。将这些成像方式与模型在制作时确定的实际尺寸进行相互比较。
在这项初步研究中,所有成像方式在测量AAA模型尺寸的能力方面相对相似。长度测量占机构间和观察者间差异的大部分。MR成像的差异最小。
作者开发了一种新的模型,其能够以重复、可再现的方式成功地用CA、CT、MR成像和IVUS进行成像。对这类模型进行结构优化以及未来更大规模、具有统计学意义的评估,应能将其确立为多中心腔内支架移植物试验中的有用辅助工具,以便校准成像方式并确定哪种成像方式最适合术前AAA尺寸测量。