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Abdominal aortic aneurysm diameter: a comparison of ultrasound measurements with those from standard and three-dimensional computed tomography reconstruction.

Manning, Brian J; Kristmundsson, Thorarinn; Sonesson, Björn LU and Resch, Timothy (2009) In Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter 50(2). p.263-268
Abstract
OBJECTIVE: Aortic aneurysm size is a critical determinant of the need for intervention, yet the maximal diameter will often vary depending on the modality and method of measurement. We aimed to define the relationship between commonly used computed tomography (CT) measurement techniques and those based on current reporting standards and to compare the values obtained with diameter measured using ultrasound (US). METHODS: CT scans from patients with US-detected aneurysms were analyzed using three-dimensional reconstruction software. Maximal aortic diameter was recorded in the anteroposterior (CT-AP) plane, along the maximal ellipse (CT-ME), perpendicular to the maximal ellipse (CT-PME), or perpendicular to the centerline of flow (CT-PCLF).... (More)
OBJECTIVE: Aortic aneurysm size is a critical determinant of the need for intervention, yet the maximal diameter will often vary depending on the modality and method of measurement. We aimed to define the relationship between commonly used computed tomography (CT) measurement techniques and those based on current reporting standards and to compare the values obtained with diameter measured using ultrasound (US). METHODS: CT scans from patients with US-detected aneurysms were analyzed using three-dimensional reconstruction software. Maximal aortic diameter was recorded in the anteroposterior (CT-AP) plane, along the maximal ellipse (CT-ME), perpendicular to the maximal ellipse (CT-PME), or perpendicular to the centerline of flow (CT-PCLF). Diameter measurements were compared with each other and with maximal AP diameter according to US (US-AP). Analysis was performed according to the principles of Bland and Altman. Results are expressed as mean +/- standard deviation. RESULTS: CT and US scans from 109 patients (92 men, 17 women), with a mean age of 72 +/- 8 years, were included. The mean of each series of readings on CT was significantly larger than the mean US-AP measurement (P < .001), and they also differed significantly from each other (P < .001). The CT-PCLF diameter was larger than CT-AP and CT-PME by mean values of 3.0 +/- 6.6 and 5.9 +/- 6.0 mm, respectively. The CT-ME diameter was larger than CT-PCLF by a mean of 2.4 +/- 5 mm. The US-AP diameter was smaller than CT-AP diameter by 4.2 +/- 4.9 mm, CT-ME by 9.6 +/- 8.0 mm, CT-PME by 1.3 +/- 5 mm, and smaller than CT-PCLF by 7.3 +/- 7.0 mm. Aneurysm size did not significantly affect these differences. Seventy-eight percent of 120 pairs of intraobserver CT measurements and 65% of interobserver CT measurements differed by <2 mm. CONCLUSIONS: CT-based measurements of aneurysm size tend to be larger than the US-AP measurement. CT-PCLF diameters are consistently larger than CT-PME as well as CT-AP measurements. These differences should be considered when applying evidence from previous trials to clinical decisions. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
volume
50
issue
2
pages
263 - 268
publisher
Mosby
external identifiers
  • WOS:000268610000004
  • PMID:19631858
  • Scopus:67650963861
ISSN
1097-6809
DOI
10.1016/j.jvs.2009.02.243
language
English
LU publication?
yes
id
3c4a8513-34f7-4b6b-98f5-98412d07ebd6 (old id 1452791)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19631858?dopt=Abstract
date added to LUP
2009-08-05 10:43:40
date last changed
2017-01-01 07:46:58
@article{3c4a8513-34f7-4b6b-98f5-98412d07ebd6,
  abstract     = {OBJECTIVE: Aortic aneurysm size is a critical determinant of the need for intervention, yet the maximal diameter will often vary depending on the modality and method of measurement. We aimed to define the relationship between commonly used computed tomography (CT) measurement techniques and those based on current reporting standards and to compare the values obtained with diameter measured using ultrasound (US). METHODS: CT scans from patients with US-detected aneurysms were analyzed using three-dimensional reconstruction software. Maximal aortic diameter was recorded in the anteroposterior (CT-AP) plane, along the maximal ellipse (CT-ME), perpendicular to the maximal ellipse (CT-PME), or perpendicular to the centerline of flow (CT-PCLF). Diameter measurements were compared with each other and with maximal AP diameter according to US (US-AP). Analysis was performed according to the principles of Bland and Altman. Results are expressed as mean +/- standard deviation. RESULTS: CT and US scans from 109 patients (92 men, 17 women), with a mean age of 72 +/- 8 years, were included. The mean of each series of readings on CT was significantly larger than the mean US-AP measurement (P &lt; .001), and they also differed significantly from each other (P &lt; .001). The CT-PCLF diameter was larger than CT-AP and CT-PME by mean values of 3.0 +/- 6.6 and 5.9 +/- 6.0 mm, respectively. The CT-ME diameter was larger than CT-PCLF by a mean of 2.4 +/- 5 mm. The US-AP diameter was smaller than CT-AP diameter by 4.2 +/- 4.9 mm, CT-ME by 9.6 +/- 8.0 mm, CT-PME by 1.3 +/- 5 mm, and smaller than CT-PCLF by 7.3 +/- 7.0 mm. Aneurysm size did not significantly affect these differences. Seventy-eight percent of 120 pairs of intraobserver CT measurements and 65% of interobserver CT measurements differed by &lt;2 mm. CONCLUSIONS: CT-based measurements of aneurysm size tend to be larger than the US-AP measurement. CT-PCLF diameters are consistently larger than CT-PME as well as CT-AP measurements. These differences should be considered when applying evidence from previous trials to clinical decisions.},
  author       = {Manning, Brian J and Kristmundsson, Thorarinn and Sonesson, Björn and Resch, Timothy},
  issn         = {1097-6809},
  language     = {eng},
  number       = {2},
  pages        = {263--268},
  publisher    = {Mosby},
  series       = {Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter},
  title        = {Abdominal aortic aneurysm diameter: a comparison of ultrasound measurements with those from standard and three-dimensional computed tomography reconstruction.},
  url          = {http://dx.doi.org/10.1016/j.jvs.2009.02.243},
  volume       = {50},
  year         = {2009},
}