Discrepancies in Vessel Diameter Measurements Between CTA and DSA in MCA M1 Occlusions: An Interobserver Study.

IF 3.7 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes Pub Date : 2025-07-26 DOI:10.1177/08465371251356908

Patrick Rogers, Ellen Parker, Marco Marangoni, Ian R MacDonald, Cha-Ney Kim, Eef J Hendriks, David Volders

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引用次数: 0

Abstract

Purpose: Accurate vessel measurement is essential in endovascular thrombectomy (EVT) for acute ischemic stroke. Discrepancies between computed tomography angiography (CTA) and digital subtraction angiography (DSA) may impact procedural planning and device selection. This study compares vessel diameter measurements from CTA and DSA in patients with middle cerebral artery (MCA) M1 occlusions.

Methods: In this single-center retrospective study, 90 consecutive patients who underwent EVT for MCA M1 occlusions between February 2020 and March 2024 were included. Vessel diameters were independently measured by 3 neuroradiologists using CTA and DSA (pre- and post-intervention). Statistical analysis included Wilcoxon signed-rank tests, intraclass correlation coefficient (ICC), and Bland-Altman analysis.

Results: CTA consistently overestimated vessel diameter compared to DSA. The mean M1 diameter was 2.29 ± 0.27 mm on CTA and 2.16 ± 0.30 mm on pre-EVT DSA (P < .001), with a median difference of 0.4 mm (IQR: 0.2-0.6 mm). In 70% of cases, CTA values exceeded DSA. Bland-Altman analysis confirmed a mean difference of +0.13 mm (limits of agreement: -0.25 to +0.51 mm). No significant change was observed between pre- and post-EVT DSA measurements (P = .103). Clot-side M1 segments were significantly smaller than contralateral measurements on CTA (P = .003). Inter-rater agreement was good (ICC = .785).

Conclusions: CTA overestimates MCA M1 diameter relative to DSA. While the discrepancy is modest, it may influence device selection in borderline cases. Awareness of this variability is important, and further research is warranted to explore its clinical implications.

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CTA和DSA在MCA M1闭塞中的血管直径测量差异：一项观察者间研究。

目的：准确的血管测量是急性缺血性脑卒中血管内取栓术的关键。计算机断层血管造影（CTA）和数字减影血管造影（DSA）之间的差异可能会影响手术计划和设备选择。本研究比较了大脑中动脉（MCA） M1闭塞患者的CTA和DSA血管直径测量。方法：在这项单中心回顾性研究中，纳入了2020年2月至2024年3月期间连续90例因MCA M1闭塞接受EVT治疗的患者。血管直径由3名神经放射科医生分别使用CTA和DSA测量（干预前和干预后）。统计分析包括Wilcoxon符号秩检验、类内相关系数（ICC）和Bland-Altman分析。结果：与DSA相比，CTA持续高估血管直径。CTA检查M1平均直径为2.29±0.27 mm， evt前DSA检查M1平均直径为2.16±0.30 mm (P < 0.001)，中位差为0.4 mm （IQR: 0.2 ~ 0.6 mm）。70%的病例CTA值高于DSA。Bland-Altman分析证实平均差值为+0.13 mm（一致限：-0.25至+0.51 mm）。evt前后DSA测量无显著变化（P = 0.103）。凝块侧M1段明显小于对侧CTA测量值（P = 0.003）。评分者间一致性良好（ICC = .785）。结论：相对于DSA， CTA高估了MCA M1直径。虽然差异是适度的，但它可能会影响边缘情况下的设备选择。认识到这种可变性是很重要的，进一步的研究是必要的，以探索其临床意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes 医学-核医学

CiteScore

6.20

自引率

12.90%

发文量

审稿时长

6-12 weeks

期刊介绍： The Canadian Association of Radiologists Journal is a peer-reviewed, Medline-indexed publication that presents a broad scientific review of radiology in Canada. The Journal covers such topics as abdominal imaging, cardiovascular radiology, computed tomography, continuing professional development, education and training, gastrointestinal radiology, health policy and practice, magnetic resonance imaging, musculoskeletal radiology, neuroradiology, nuclear medicine, pediatric radiology, radiology history, radiology practice guidelines and advisories, thoracic and cardiac imaging, trauma and emergency room imaging, ultrasonography, and vascular and interventional radiology. Article types considered for publication include original research articles, critically appraised topics, review articles, guest editorials, pictorial essays, technical notes, and letter to the Editor.