Document Detail


Impact of image analysis methodology on diagnostic and surgical classification of patients with thoracic aortic aneurysms.
MedLine Citation:
PMID:  21723533     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: For patients with thoracic aortic aneurysms (TAA), aortic size on imaging is widely used to guide clinical decision making. This study examined the impact of methodological variance on aortic quantification.
METHODS: We studied enrollees in the National Registry of Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions. Aortic size on computed tomography was quantified by 2 linear methods; cross-sectional dimensions in axial (AX) and double oblique (DO) plane. Calculated area was compared to planimetry. Established cutoffs (area/height>10 cm2/m, diameter≥5 cm) for prophylactic TAA repair were used to compare surgical eligibility by each method.
RESULTS: Fifty subjects were studied. Aortic size differed between AX and DO at all locations (p≤0.001), with magnitude greatest at the sinotubular junction (4.8±1.1 vs 4.0±1.0 cm, p<0.001). The difference between AX and DO correlated with aortic angular displacement (r=0.37, p<0.01), which was threefold larger at the sinotubular junction (37±12 degrees) than the ascending aorta (12±5 degrees; p<0.001). At all locations, aortic area calculated using DO yielded smaller differences with planimetry than AX (p<0.05). DO and planimetry yielded equal prevalence (24%) of subjects eligible for prophylactic TAA repair based on area-height cutoff, whereas AX prevalence was higher (44%; p=0.006). Using a linear cutoff, AX yielded over a twofold greater prevalence of surgically eligible subjects (56%) than did DO (24%; p<0.001).
CONCLUSIONS: Established linear methods for aortic measurement yield different results that impact surgical eligibility. DO yielded improved agreement with planimetry and differed with AX in proportion to aortic geometric obliquity. Findings support DO measurements for imaging evaluation of subjects with TAA.
Authors:
Dorinna D Mendoza; Minisha Kochar; Richard B Devereux; Craig T Basson; James K Min; Kathryn Holmes; Harry C Dietz; Dianna M Milewicz; Scott A LeMaire; Reed E Pyeritz; Joseph E Bavaria; Cheryl L Maslen; Howard Song; Barbara L Kroner; Kim A Eagle; Jonathan W Weinsaft;
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural     Date:  2011-07-02
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  92     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-29     Completed Date:  2011-11-02     Revised Date:  2014-04-08    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  904-12     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aorta, Thoracic / radiography*,  surgery
Aortic Aneurysm, Thoracic* / classification,  radiography,  surgery
Decision Making*
Female
Follow-Up Studies
Humans
Image Processing, Computer-Assisted / methods*
Male
Reproducibility of Results
Retrospective Studies
Severity of Illness Index
Vascular Surgical Procedures*
Grant Support
ID/Acronym/Agency:
HHSN268200648199C/ADB/AD/ADAMHA HHS; K23-HL63268/HL/NHLBI NIH HHS; N01-HV-68199/HV/NHLBI NIH HHS; UL1 RR024140/RR/NCRR NIH HHS; UL1-RR024996/RR/NCRR NIH HHS
Comments/Corrections
Comment In:
Ann Thorac Surg. 2011 Sep;92(3):913   [PMID:  21871276 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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