Three-dimensional aortic geometry mapping via registration of non-gated contrast-enhanced or gated and respiratory-navigated MR angiographies.

IF 4.2 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Lydia Dux-Santoy, Jose F Rodríguez-Palomares, Gisela Teixidó-Turà, Juan Garrido-Oliver, Alejandro Carrasco-Poves, Alberto Morales-Galán, Aroa Ruiz-Muñoz, Guillem Casas, Filipa Valente, Laura Galian-Gay, Rubén Fernández-Galera, Ruperto Oliveró, Hug Cuéllar-Calabria, Albert Roque, Gemma Burcet, José A Barrabés, Ignacio Ferreira-González, Andrea Guala
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引用次数: 0

Abstract

Background: The measurement of aortic dimensions and their evolution are key in the management of patients with aortic diseases. Manual assessment, the current guideline-recommended method and clinical standard, is subjective, poorly reproducible, and time-consuming, limiting the capacity to track aortic growth in everyday practice. Aortic geometry mapping (AGM) via image registration of serial computed tomography angiograms outperforms manual assessment, providing accurate and reproducible 3D maps of aortic diameter and growth rate. This observational study aimed to evaluate the accuracy and reproducibility of AGM on non-gated contrast-enhanced (CE-) and cardiac- and respiratory-gated (GN-) magnetic resonance angiographies (MRA).

Methods: Patients with thoracic aortic disease followed with serial CE-MRA (n = 30) or GN-MRA (n = 15) acquired at least 1 year apart were retrospectively and consecutively identified. Two independent observers measured aortic diameters and growth rates (GR) manually at several thoracic aorta reference levels and with AGM. Agreement between manual and AGM measurements and their inter-observer reproducibility were compared. Reproducibility for aortic diameter and GR maps assessed with AGM was obtained.

Results: Mean follow-up was 3.8 ± 2.3 years for CE- and 2.7 ± 1.6 years for GN-MRA. AGM was feasible in the 93% of CE-MRA pairs and in the 100% of GN-MRA pairs. Manual and AGM diameters showed excellent agreement and inter-observer reproducibility (ICC>0.9) at all anatomical levels. Agreement between manual and AGM GR was more limited, both in the aortic root by GN-MRA (ICC=0.47) and in the thoracic aorta, where higher accuracy was obtained with GN- than with CE-MRA (ICC=0.55 vs 0.43). The inter-observer reproducibility of GR by AGM was superior compared to manual assessment, both with CE- (thoracic: ICC= 0.91 vs 0.51) and GN-MRA (root: ICC=0.84 vs 0.52; thoracic: ICC=0.93 vs 0.60). AGM-based 3D aortic size and growth maps were highly reproducible (median ICC >0.9 for diameters and >0.80 for GR).

Conclusion: Mapping aortic diameter and growth on MRA via 3D image registration is feasible, accurate and outperforms the current manual clinical standard. This technique could broaden the possibilities of clinical and research evaluation of patients with aortic thoracic diseases.

通过对非门控造影剂增强或门控和呼吸导航磁共振血管造影进行配准,绘制三维主动脉几何图形。
背景:主动脉尺寸的测量及其演变是治疗主动脉疾病患者的关键。人工评估是目前指南推荐的方法和临床标准,但这种方法主观性强、可重复性差、耗时长,限制了在日常实践中跟踪主动脉生长的能力。通过对连续计算机断层扫描血管造影进行图像注册绘制的主动脉几何图形(AGM)优于人工评估,可提供准确且可重复的主动脉直径和生长速度三维图。这项观察性研究旨在评估 AGM 在非门控造影剂增强(CE-)和心脏与呼吸门控(GN-)磁共振血管造影(MRA)上的准确性和可重复性:方法:回顾性地连续确定了连续获得 CE-MRA (30 人)或 GN-MRA (15 人)的胸主动脉疾病患者。两名独立的观察者在几个胸主动脉参考水平上手动测量主动脉直径和生长率 (GR),并使用 AGM 测量。比较了人工测量和 AGM 测量之间的一致性及其观察者之间的再现性。结果:CE-MRA和GN-MRA的平均随访时间分别为3.8±2.3年和2.7±1.6年。93%的 CE-MRA 成对和 100% 的 GN-MRA 成对均可进行 AGM。在所有解剖层面上,手动和 AGM 直径显示出极好的一致性和观察者间的可重复性(ICC>0.9)。在主动脉根部的 GN-MRA(ICC=0.47)和胸主动脉,手动和 AGM GR 之间的一致性较为有限,在胸主动脉,GN-比 CE-MRA 获得更高的准确性(ICC=0.55 对 0.43)。与人工评估相比,AGM 对 GR 的观察者间可重复性更好,CE-(胸部:ICC= 0.91 vs 0.51)和 GN-MRA(根部:ICC=0.84 vs 0.52;胸部:ICC=0.93 vs 0.60)均是如此。基于 AGM 的三维主动脉大小和生长图具有很高的可重复性(直径的中位 ICC >0.9,GR >0.80):结论:通过三维图像配准在 MRA 上绘制主动脉直径和生长图是可行的、准确的,并且优于目前的手动临床标准。这项技术可拓宽胸主动脉疾病患者的临床和研究评估范围。
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来源期刊
CiteScore
10.90
自引率
12.50%
发文量
61
审稿时长
6-12 weeks
期刊介绍: Journal of Cardiovascular Magnetic Resonance (JCMR) publishes high-quality articles on all aspects of basic, translational and clinical research on the design, development, manufacture, and evaluation of cardiovascular magnetic resonance (CMR) methods applied to the cardiovascular system. Topical areas include, but are not limited to: New applications of magnetic resonance to improve the diagnostic strategies, risk stratification, characterization and management of diseases affecting the cardiovascular system. New methods to enhance or accelerate image acquisition and data analysis. Results of multicenter, or larger single-center studies that provide insight into the utility of CMR. Basic biological perceptions derived by CMR methods.
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