摘要
目的:以三维数字减影血管造影(three-dimensional digital subtraction angiography,3D-DSA)为“金标准”,基于CT血管成像(CT angiography,CTA)对比最大密度投影(maximum intensity projection,MIP)联合多平面重组(multiplanar reconstruction,MPR)和减影的容积再现(volume rendering,VR)这2种图像后处理方法之间颅内动脉瘤形态学参数测量结果的差异。方法:回顾性分析重庆医科大学附属第一医院92例(共116个颅内未破裂动脉瘤)患者的头颈CTA和DSA影像资料。使用双盲法分别在3D-DSA的VR、CTA的MIP-MPR和减影VR图像上测量动脉瘤的形态学参数,测量2次取均值,并计算相关的形态学衍生指标。使用组内相关系数(intraclass correlation coefficient,ICC)比较观察者间测量值的一致性,利用重复测量的方差分析或Friedman秩和检验比较不同后处理图像上测量结果的差异,后续组间两两比较采用Bonferroni校正。采用卡方检验对比各组小、微小动脉瘤及宽颈动脉瘤的分布情况。结果:基于MIP-MPR、减影VR和3D-DSA测得的动脉瘤最大径、瘤宽和瘤高在三组间整体比较时差异无统计学意义(χ^(2)值分别为4.484、5.808、4.468,均P>0.05);而得到的颈宽、载瘤动脉的平均直径在三组间整体比较时差异有统计学意义(χ^(2)值分别为48.341、87.948,均P<0.001);进行后续的组间两两比较时结果存在差异,且这种差异在颈内动脉虹吸部与非虹吸部2个亚组内又有一定区别。由MIP-MPR得出的形态学衍生指标均偏大,与DSA相比差异均有统计学意义(P<0.017),除高宽比外,与减影VR相比差异也有统计学意义(P<0.017)。基于减影VR进行动脉瘤的形态学评估,仅载瘤动脉的平均直径和大小比与DSA相比差异有统计学意义(P<0.017),但载瘤动脉的平均直径测量差异在亚组分析时不明显(P>0.017);其余参数与DSA相比差异均无统计学意义(P>0.017)。结论:减影VR上颅内动脉瘤形态学参数测量的准确性优
Objective:To compare two image post-processing methods based on computed tomography angiography(CTA)—maximum intensity projection(MIP)combined with multiplanar reconstruction(MPR)versus subtracted volume rendering(VR)for morphological assessment of intracranial aneurysms,using three-dimensional digital subtraction angiography(3D-DSA)as the gold standard.Methods:We retrospectively analyzed the CTA and DSA data of the head and neck of 92 patients involving 116 unruptured intracranial aneurysms in the First Affiliated Hospital of Chongqing Medical University.Double-blind measurement of the morphological parameters of intracranial aneurysms was performed on 3D-DSA VR images,CTA MIP-MPR images,and subtracted CTA VR images.Two measurements each were performed to calculate the average values,and relevant derived morphological indices were computed.The intraclass correlation coefficient(ICC)was used to assess the consistency of measurements between observers.The measurement results with different post-processing methods were compared using repeated-measures analysis of variance and the Friedman rank sum test.The Bonferroni correction was used for subsequent pairwise comparisons.The distribution of microaneurysms,small aneurysms,and wide-necked aneurysms between groups was compared using the chi-square test.Results:The maximum diameter,width,and height of intracranial aneurysm measured with MIP-MPR,subtracted VR and DSA showed no significant differences(χ^(2)=4.484,5.808,and 4.468 respectively,all P>0.05).The neck width and the mean diameter of the parent artery differed significantly among the three groups overall(χ^(2)=48.341,87.948,both P<0.001),Subsequent pairwise comparisons between any two groups revealed differences,with further differences also observed in terms of whether aneurysms were located at the siphon of the internal carotid artery or not.In addition,the derived morphological indicators measured with MIP-MPR were all greater,which were significantly different compared with DSA(P<0.017),and also signifi
作者
吴钖莹
张丽娟
康绍磊
王国树
吕发金
Wu Yangying;Zhang Lijuan;Kang Shaolei;Wang Guoshu;LüFajin(Department of Radiology,The First Affiliated Hospital of Chongqing Medical University;Department of Radiology,The First Affiliated Hospital of Kunming Medical University)
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2024年第8期1052-1057,共6页
Journal of Chongqing Medical University
关键词
颅内动脉瘤
图像后处理
形态学
最大密度投影
多平面重组
容积再现
intracranial aneurysm
image post-processing
morphology
maximum intensity projection
multiplanar reconstruction
volume rendering
