What Is the Optimal Abdominal Aortic Aneurysm Sac Measurement on CT Images during Follow-up after Endovascular Repair?
| Autor: | Jieming Fang, Vasillios Raptopoulos, Olga R. Brook, Nathaniel Temin, Alexander Brook, Johannes Boos |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Radiography Abdominal medicine.medical_specialty Computed Tomography Angiography 030204 cardiovascular system & hematology Sensitivity and Specificity 030218 nuclear medicine & medical imaging 03 medical and health sciences Aortic aneurysm 0302 clinical medicine Aneurysm medicine.artery medicine Humans Radiology Nuclear Medicine and imaging Renal artery Computed tomography angiography Aged Aged 80 and over medicine.diagnostic_test business.industry Endovascular Procedures Reproducibility of Results Aortic bifurcation Middle Aged medicine.disease Abdominal aortic aneurysm Aortic Aneurysm Radiographic Image Enhancement medicine.anatomical_structure Treatment Outcome Coronal plane Angiography Female Radiology business Follow-Up Studies |
| Zdroj: | Radiology. 285(3) |
| ISSN: | 1527-1315 |
| Popis: | Purpose To develop a computed tomographic (CT) angiographic postprocessing protocol with two- and three-dimensional measurements for follow-up of patients who underwent endovascular aortic repair. Materials and Methods This HIPAA-compliant institutional review board-approved retrospective study included 159 patients (129 men, 30 women; mean age ± standard deviation, 74.9 years ± 8.2) who underwent 824 CT examinations (median of five examinations per patient; range, two to 14) with unenhanced and arterial -phase imaging performed between September 2004 and March 2015. The largest diameter on the axial plane; coronal, sagittal, and maximal diameter perpendicular to the reconstructed centerline; volume of the abdominal aortic aneurysm sac; and volume from the lowest renal artery to the aortic bifurcation and to the common iliac artery bifurcation were measured. Endoleaks on contrast material-enhanced images were considered the reference standard, and the predictive value of diameter and volume changes was analyzed. Intraclass correlation was used to compare diameters and volumes. Results All diameters and volumes showed excellent correlation (intraclass coefficient, 0.95 and 0.94, respectively). Average interobserver difference for diameters and volumes was 2%-3% and 4%-12%, respectively. Endoleaks were observed in 80 (50%) of 159 patients (59 [74%] at initial and 21 [26%] at later CT angiography). New endo-leaks were associated with increased aneurysm size measured as the largest diameter on the axial plane (P = .04) and perpendicular to the centerline (P = .01), and volume was measured from the lowest renal artery to the aortic bifurcation (P = .03) and to the common iliac artery bifurcation (P = .01). With a 5% size threshold, sensitivity and specificity for detection of endoleaks was optimal for centerline diameter (64.3% and 81.7%, respectively) and volume from the lowest renal artery to the common iliac artery bifurcation (57.1% and 63.5%). Conclusion The maximal diameter and volume of an abdominal aortic aneurysm sac can be used for temporal monitoring after endovascular aortic repair, with excellent correlation and interobserver agreement. An increase in the centerline diameter and volume from the lowest renal artery to the iliac bifurcation were the most sensitive criteria for detecting endoleaks. © RSNA, 2017 Online supplemental material is available for this article. |
| Databáze: | OpenAIRE |
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