TY - JOUR
T1 - Critical appraisal of multidimensional CT measurements following acute open repair of type A aortic dissection
AU - Houben, Ignas B.
AU - van Bakel, Theodorus M.J.
AU - Burris, Nicholas S.
AU - Moll, Frans L.
AU - van Herwaarden, Joost A.
AU - Patel, Himanshu J.
N1 - © 2020 The Authors. Journal of Cardiac Surgery published by Wiley Periodicals, Inc.
PY - 2020/3/1
Y1 - 2020/3/1
N2 - INTRODUCTION: To identify patients with aneurysmal degeneration of the native aorta following type A aortic dissection (TAAD), reproducible serial measurements of aortic dimensions are critical. We used a systematic workflow for measuring aortic geometry following TAAD, using computed tomography angiography data, and test its reproducibility.METHODS: The workflow for aortic measurements included centerline generation, luminal diameter, and area measurement at six anatomically defined locations along the aorta and luminal volumetric measurements in the descending aorta. Two independent observers measured the aortic geometry in 20 surgically repaired TAAD patients, preoperatively and at 3 months follow-up. To test reproducibility, intraobserver and interobserver agreement scores were analyzed using a concordance correlation coefficient (CCC).RESULTS: The interobserver agreement scores of the diameter, area, and volumetric measurements in the descending aorta were acceptable. The agreement scores of the area measurements were highest, with CCCs ranging from 0.909 to 0.984. Luminal diameter measurements scored lower than luminal area measurements and were least reproducible at the mid aortic arch (CCC < 0.886). Overall, intraobserver agreement scores were better than interobserver agreement scores (SD of mean difference was 1.89 vs 1.94 for intraobserver vs interobserver diameter measurements, and 0.61 vs 0.66 for area measurements).CONCLUSION: Although overall reproducibility was acceptable in descending aortic measurements, our results show that it remains challenging to reliably measure luminal diameters, compared with areas. To aid identification of early adverse remodeling following acute TAAD, novel two- and three-dimensional measurement techniques are needed that capture locoregional changes in the false lumen and true lumen morphology more accurately.
AB - INTRODUCTION: To identify patients with aneurysmal degeneration of the native aorta following type A aortic dissection (TAAD), reproducible serial measurements of aortic dimensions are critical. We used a systematic workflow for measuring aortic geometry following TAAD, using computed tomography angiography data, and test its reproducibility.METHODS: The workflow for aortic measurements included centerline generation, luminal diameter, and area measurement at six anatomically defined locations along the aorta and luminal volumetric measurements in the descending aorta. Two independent observers measured the aortic geometry in 20 surgically repaired TAAD patients, preoperatively and at 3 months follow-up. To test reproducibility, intraobserver and interobserver agreement scores were analyzed using a concordance correlation coefficient (CCC).RESULTS: The interobserver agreement scores of the diameter, area, and volumetric measurements in the descending aorta were acceptable. The agreement scores of the area measurements were highest, with CCCs ranging from 0.909 to 0.984. Luminal diameter measurements scored lower than luminal area measurements and were least reproducible at the mid aortic arch (CCC < 0.886). Overall, intraobserver agreement scores were better than interobserver agreement scores (SD of mean difference was 1.89 vs 1.94 for intraobserver vs interobserver diameter measurements, and 0.61 vs 0.66 for area measurements).CONCLUSION: Although overall reproducibility was acceptable in descending aortic measurements, our results show that it remains challenging to reliably measure luminal diameters, compared with areas. To aid identification of early adverse remodeling following acute TAAD, novel two- and three-dimensional measurement techniques are needed that capture locoregional changes in the false lumen and true lumen morphology more accurately.
KW - 3D imaging
KW - angiographic computed tomography
KW - diameter
KW - false lumen
KW - interrater agreement
KW - morphology
KW - type A dissection
UR - http://www.scopus.com/inward/record.url?scp=85079153379&partnerID=8YFLogxK
U2 - 10.1111/jocs.14446
DO - 10.1111/jocs.14446
M3 - Article
C2 - 32027413
AN - SCOPUS:85079153379
SN - 0886-0440
VL - 35
SP - 634
EP - 644
JO - Journal of Cardiac Surgery
JF - Journal of Cardiac Surgery
IS - 3
ER -