Comparison of CT image post-processing methods for the accuracy of morphological measurement of intracranial aneurysms

Wu Yangying, Zhang Lijuan, Kang Shaolei, Wang Guoshu, Fajin Lü

PDF(1102 KB)
PDF(1102 KB)
Journal of Chongqing Medical University ›› 2024, Vol. 49 ›› Issue (08) : 1052-1057. DOI: 10.13406/j.cnki.cyxb.003562
Medical imaging

Comparison of CT image post-processing methods for the accuracy of morphological measurement of intracranial aneurysms

Author information +
History +

Abstract

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=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=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 significantly different compared with subtracted VR except for the height-to-width ratio(P<0.017). In the morphological assessment of aneurysms based on subtracted VR,only the average diameter of the parent artery and the size ratio showed significant differences compared with DSA(P<0.017),and the difference in the average diameter of the parent artery was not significant in subgroup analysis;there were no significant differences in the other parameters between subtracted VR and DSA. Conclusion Subtracted VR is more accurate in measuring the morphological parameters of intracranial aneurysms than MIP-MPR,and is more suitable for morphological assessment of internal carotid artery siphon aneurysms.

Key words

intracranial aneurysm / image post-processing / morphology / maximum intensity projection / multiplanar reconstruction / volume rendering

CLC number

R743 / R816.1

Cite this article

Download Citations
Wu Yangying , Zhang Lijuan , Kang Shaolei , et al . Comparison of CT image post-processing methods for the accuracy of morphological measurement of intracranial aneurysms. Journal of Chongqing Medical University. 2024, 49(08): 1052-1057 https://doi.org/10.13406/j.cnki.cyxb.003562

References

1
Etminan N MacDonald RL. Neurovascular disease,diagnosis,and therapy:subarachnoid hemorrhage and cerebral vasospasm[J]. Handb Clin Neurol2021176:135-169.
2
Wang GX Liu J Chen YQ,et al. Morphological characteristics associated with the rupture risk of mirror posterior communicating artery aneurysms[J]. J Neurointerv Surg201810(10):995-998.
3
黄 中,姜 雪,蔡焰,等. 基于容积CT数字减影血管成像对颈内虹吸部动脉瘤破裂风险的研究[J]. 中国医学计算机成像杂志202228(1):26-31.
Huang Z Jiang X Cai Y,et al. Study on the risk of aneurysm rupture in the siphon of the neck based on volumetric CT digital subtraction angiography[J]. Chin Comput Med Imag202228(1):26-31.
4
中国医师协会神经介入专业委员会,中国颅内动脉瘤计划研究组. 颅内动脉瘤影像学判读专家共识 [J]. 中国脑血管病杂志202118(7):492-504.
Chinese Federation of Interventional and Therapeutic Neuroradiology,Chinese Intracranial Aneurysm Project Study Group. Expert consensus on imaging interpretation of intracranial aneurysms [J]. Chin J Cerebrovasc Dis202118(7):492-504.
5
Dhar S Tremmel M Mocco J,et al. Morphology parameters for intracranial aneurysm rupture risk assessment[J]. Neurosurgery200863(2):185-196.
6
Rajabzadeh-Oghaz H Varble N Shallwani H,et al. Computer-assisted three-dimensional morphology evaluation of intracranial aneurysms[J]. World Neurosurg2018119:541-550.
7
Geng JW Hu P Ji Z,et al. Accuracy and reliability of computer-assisted semi-automated morphological analysis of intracranial aneurysms:an experimental study with digital phantoms and clinical aneurysm cases[J]. Int J Comput Assist Radiol Surg202015(10):1749-1759.
8
耿介文,吉 喆,沈杰,等. 不同经验医师测量颅内动脉瘤形态学参数的一致性分析[J]. 中国脑血管病杂志201916(12):633-636.
Geng JW Ji Z Shen J,et al. Consistency analysis of aneurysm morphological parameters measurements by different experienced physicians[J]. Chin J Cerebrovasc Dis201916(12):633-636.
9
Kim HJ Yoon DY Kim ES,et al. Intraobserver and interobserver variability in CT angiography and MR angiography measurements of the size of cerebral aneurysms[J]. Neuroradiology201759(5):491-497.
10
蒋永明. MSCTA图像后处理技术对颅内动脉瘤的应用价值[J]. 检验医学与临床201714(21):3189-3190,3192.
Jiang YM. Application value of MSCTA image post-processing technique in intracranial aneurysms[J]. Lab Med Clin201714(21):3189-3190,3192.
11
王晓慧,杨 娟,张瑜. 3D-CTA对颅内动脉瘤诊断效能及治疗指导的价值研究[J]. 中国CT和MRI杂志202220(1):18-20.
Wang XH Yang J Zhang Y. Study on diagnostic efficacy of 3D-CTA on intracranial aneurysms and value of treatment guidance[J]. Chin J CT MRI202220(1):18-20.
12
Fernandez Zubillaga A Guglielmi G Viñuela F,et al. Endovascular occlusion of intracranial aneurysms with electrically detachable coils:correlation of aneurysm neck size and treatment results[J]. AJNR Am J Neuroradiol199415(5):815-820.
13
Vinacci G Celentano A Agosti E,et al. Comaneci-assisted coiling of wide-necked intracranial aneurysm:a single-center preliminary experience[J]. J Clin Med202211(22):6650.
14
Pierot L Cognard C Anxionnat R,et al. Endovascular treatment of ruptured intracranial aneurysms:factors affecting midterm quality anatomic results:analysis in a prospective,multicenter series of patients(CLARITY)[J]. AJNR Am J Neuroradiol201233(8):1475-1480.
15
Nakazaki M Nonaka T Nomura T,et al. Cerebral aneurysm neck diameter is an independent predictor of progressive occlusion after stent-assisted coiling[J]. Acta Neurochir2017159(7):1313-1319.
16
付培基. 颅内动脉瘤栓塞辅助支架贴壁情况观察及影响因素分析[D]. 郑州:郑州大学,2020
Fu PJ. Observation of the stent attachment of stent-assisted embolization of intracranial aneurysms and analysis of the influencing factors[D]. Zhengzhou:Zhengzhou University,2020
17
Pei YS Xu ZH Liang GB,et al. Risk factors of anterior circulation intracranial aneurysm rupture:extracranial carotid artery tortuosity and aneurysm morphologic parameters[J]. Front Neurol202112:693549.

Comments

PDF(1102 KB)

Accesses

Citation

Detail

Sections
Recommended

/