Interobserver and intraobserver variability in measuring the tortuosity of the thoracic aorta on computed tomography

Chen, Chun-Ku; Chou, Hsiao-Ping; Guo, Chao-Yu; Chang, Hsiao-Ting; Chang, Yu-Lung; Chen, I‐Ming; Wu, Mei-Han; Shih, Chang-tai

doi:10.1016/j.jvs.2018.01.047

Cited by 13 publications

(9 citation statements)

References 27 publications

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“…The index was defined as the shortest distance between A and B divided by the centre lumen line distance between A and B. 20 Tortuosity angle of each landing zone was measured using the "tortuosity angle function", which is calculated between two line elements that are defined by three control points located on the centreline (Fig. 4).…”

Section: Methodsmentioning

confidence: 99%

Geometric Pattern of Proximal Landing Zones for Thoracic Endovascular Aortic Repair in the Bovine Arch Variant

Marrocco-Trischitta

Alaidroos

Romarowski

et al. 2020

European Journal of Vascular and Endovascular Surgery

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This work shows that the "bovine" aortic arch is associated with a consistent geometric pattern, which identifies hostile proximal landing zones for endograft deployment, namely Zone 3 and Zone 0 in Type I arch. The results suggest that the "bovine" aortic arch mandates a specific amendment to thoracic endovascular aortic repair planning. Further biomechanical studies are warranted to disclose the potential causative relationship between the described peculiar geometric features and the risk of developing thoracic aortic pathologies in patients with this anatomical variant.

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Section: Methodsmentioning

confidence: 99%

Geometric Pattern of Proximal Landing Zones for Thoracic Endovascular Aortic Repair in the Bovine Arch Variant

Marrocco-Trischitta

Alaidroos

Romarowski

et al. 2020

European Journal of Vascular and Endovascular Surgery

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“…The interexamination, interobserver, and intraobserver analysis demonstrated comparable reproducibility and repeatability for each parameter for both cohorts. Comparable interobserver reproducibility and intraobserver repeatability have previously been described for volume, centerline length, maximal diameter, and curvature radius in studies analyzing nonelectrocardiographic‐gated contrast‐enhanced MRI, 4D flow MRI, and computed tomography images in patients 21‐25 …”

Section: Discussionmentioning

confidence: 63%

Reproducibility of Aorta Segmentation on 4D Flow MRI in Healthy Volunteers

Juffermans

Westenberg

Boogaard

et al. 2020

Magnetic Resonance Imaging

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Background Hemodynamic aorta parameters can be derived from 4D flow MRI, but this requires lumen segmentation. In both commercially available and research 4D flow MRI software tools, lumen segmentation is mostly (semi‐)automatically performed and subsequently manually improved by an observer. Since the segmentation variability, together with 4D flow MRI data and image processing algorithms, will contribute to the reproducibility of patient‐specific flow properties, the observer's lumen segmentation reproducibility and repeatability needs to be assessed. Purpose To determine the interexamination, interobserver reproducibility, and intraobserver repeatability of aortic lumen segmentation on 4D flow MRI. Study Type Prospective and retrospective. Population A healthy volunteer cohort of 10 subjects who underwent 4D flow MRI twice. Also, a clinical cohort of six subjects who underwent 4D flow MRI once. Field Strength/Sequence 3T; time‐resolved three‐directional and 3D velocity‐encoded sequence (4D flow MRI). Assessment The thoracic aorta was segmented on the 4D flow MRI in five systolic phases. By positioning six planes perpendicular to a segmentation's centerline, the aorta was divided into five segments. The volume, surface area, centerline length, maximal diameter, and curvature radius were determined for each segment. Statistical Tests To assess the reproducibility, the coefficient of variation (COV), Pearson correlation coefficient (r), and intraclass correlation coefficient (ICC) were calculated. Results The interexamination and interobserver reproducibility and intraobserver repeatability were comparable for each parameter. For both cohorts there was very good reproducibility and repeatability for volume, surface area, and centerline length (COV = 10–32%, r = 0.54–0.95 and ICC = 0.65–0.99), excellent reproducibility and repeatability for maximal diameter (COV = 3–11%, r = 0.94–0.99, ICC = 0.94–0.99), and good reproducibility and repeatability for curvature radius (COV = 25–62%, r = 0.73–0.95, ICC = 0.84–0.97). Data Conclusion This study demonstrated no major reproducibility and repeatability limitations for 4D flow MRI aortic lumen segmentation. Level of Evidence 3 Technical Efficacy Stage 2

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“…1 ). The diameters, lengths, angulations [ 9 ] and tortuosity indexes [ 10 ] of the ascending aorta and aortic arch were measured at various spatial planes (Fig. 1 ).…”

Section: Methodsmentioning

confidence: 99%

“…Aortic angulations were measured by drawing tangent lines along the proximal and distal points of the centreline in the ascending aorta and aortic arch [ 9 ] (upper right panel: A1: ascending aorta angulation; A2: aortic arch angulation). Aortic tortuosity indexes were calculated as the ratio of the aortic length to the shortest linear distance between the beginning and end points in the ascending aorta and the aortic arch [ 10 ] (ascending aorta tortuosity index: T1 = L1/d1; aortic arch tortuosity index: T2 = L2/d2). Aortic arch type was identified by the vertical distance from the origin of the brachiocephalic trunk to the top of the arch.…”

Section: Methodsmentioning

confidence: 99%

Aortic arch type, a novel morphological indicator and the risk for acute type B aortic dissection

Sun

Liu

et al. 2021

Interactive CardioVascular and Thoracic Surgery

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OBJECTIVES Aortic arch type is a readily recognizable and obtainable morphological feature of the aorta that does not require complex measurements. The goal of this study was to evaluate whether aortic arch type is a comparable and alternative morphological parameter for predicting acute type B aortic dissection (aTBAD) by comparing the prognostic value of the aortic arch type with that of other morphological parameters such as aortic length, angulation and tortuosity index. METHODS The patients with aTBAD (n = 216) were matched 1:1 with a control group (n = 263) by propensity score matching. The morphological data of the ascending aorta and the aortic arch, which included diameter, length, angulation and tortuosity index, were collected on a three-dimensional aortic model using 3mensio Vascular software. The aortic arch type was identified by the vertical distance from the origin of the brachiocephalic trunk to the top of the arch. The binary logistic regression models were analysed to determine the independent geometric variables related to the aTBAD. The nonparametric approach was performed to assess whether there were statistical differences between the area under the receiver operating characteristic curves (AUC) of the models. RESULTS After propensity score matching, 151 matched pairs of patients were selected. The diameters at the sinotubular junction and the mid-ascending aorta, the ascending aorta length and the ascending aorta angulation in the aTBAD group were significantly greater than those of the controls. Compared with the control group, the diameters at the proximal aortic arch, mid-aortic arch and distal aortic arch, the angulation and the tortuosity index of the aortic arch were significantly greater in the aTBAD group. The proportion of the type III arch in the patients with aTBAD is higher than that of the type I arch and the type II arch (χ2 = 70.187; P < 0.001). Binary logistic regression analysis showed that the diameter at the mid-aortic arch, the ascending aorta length, the aortic arch angulation and the tortuosity index were independently related to the aTBAD with an AUC value of 0.887. Another binary logistic regression analysis indicated that the diameter at the mid-aortic arch and the aortic arch type were independent correlative variables associated with the aTBAD with an AUC of 0.874. No significant difference was observed in the prognostic value of receiver operating characteristic curves between the 2 models (P = 0.716). CONCLUSIONS The type III arch, which has the characteristics of aortic elongation, incremental angulation and tortuosity index, is a comparable and alternative identifier for patients at high risk for aTBAD.

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Interobserver and intraobserver variability in measuring the tortuosity of the thoracic aorta on computed tomography

Cited by 13 publications

References 27 publications

Geometric Pattern of Proximal Landing Zones for Thoracic Endovascular Aortic Repair in the Bovine Arch Variant

Geometric Pattern of Proximal Landing Zones for Thoracic Endovascular Aortic Repair in the Bovine Arch Variant

Reproducibility of Aorta Segmentation on 4D Flow MRI in Healthy Volunteers

Aortic arch type, a novel morphological indicator and the risk for acute type B aortic dissection

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