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Mora CE, Marcus CD, Barbe CM, et al. Maximum Diameter of Native Abdominal Aortic Aneurysm Measured by Angio-Computed Tomography: Reproducibility and Lack of Consensus Impacts on Clinical Decisions. Aorta (Stamford). 2015;3(2):47-55doi: 10.12945/j.aorta.2015.14-059.
Mora, C. E., Marcus, C. D., Barbe, C. M., Ecarnot, F. B., & Long, A. L. (2015). Maximum Diameter of Native Abdominal Aortic Aneurysm Measured by Angio-Computed Tomography: Reproducibility and Lack of Consensus Impacts on Clinical Decisions. Aorta (Stamford, Conn.), 3(2), 47-55. https://doi.org/10.12945/j.aorta.2015.14-059
Mora, Caroline E, et al. "Maximum Diameter of Native Abdominal Aortic Aneurysm Measured by Angio-Computed Tomography: Reproducibility and Lack of Consensus Impacts on Clinical Decisions." Aorta (Stamford, Conn.) vol. 3,2 (2015): 47-55. doi: https://doi.org/10.12945/j.aorta.2015.14-059
Mora CE, Marcus CD, Barbe CM, Ecarnot FB, Long AL. Maximum Diameter of Native Abdominal Aortic Aneurysm Measured by Angio-Computed Tomography: Reproducibility and Lack of Consensus Impacts on Clinical Decisions. Aorta (Stamford). 2015 Apr 01;3(2):47-55. doi: 10.12945/j.aorta.2015.14-059. eCollection 2015 Apr. PMID: 26798757; PMCID: PMC4686349.
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Aorta (Stamford). 2015 Apr 01;3(2):47-55. doi: 10.12945/j.aorta.2015.14-059. eCollection 2015 Apr.

Maximum Diameter of Native Abdominal Aortic Aneurysm Measured by Angio-Computed Tomography: Reproducibility and Lack of Consensus Impacts on Clinical Decisions.

Aorta (Stamford, Conn.)

Caroline E Mora, Claude D Marcus, Coralie M Barbe, Fiona B Ecarnot, Anne L Long

Affiliations

  1. Department of Radiology, University Hospital Reims, Hôpital Robert Debré, Reims, France.
  2. Clinical Research Unit, University Hospital Reims, Hôpital Robert Debré, Reims, France.
  3. EA3920, Department of Cardiology, University Hospital Besancon, Besançon, France.
  4. Department of Internal Medicine and Vascular Medicine, Pavillon M, Hospices Civils de Lyon, University Hospital Edouard Herriot, Lyon, France; Faculty of Medicine and Maieutic Charles Merieux, Claude Bernard Lyon 1 University, Oullins, France.

PMID: 26798757 PMCID: PMC4686349 DOI: 10.12945/j.aorta.2015.14-059

Abstract

BACKGROUND: Computed tomography angiography (CTA) is the reference technique for the measurement of native maximum abdominal aortic aneurysm (AAA) diameter when surgery is being considered. However, there is a wide choice available for the methodology of maximum AAA diameter measurement on CTA, and to date, no consensus has been reached on which method is best. We analyzed clinical decisions based on these various measures of native maximum AAA diameter with CTA, then analyzed their reproducibility and identified the method of measurement yielding the highest agreement in terms of patient management.

MATERIALS AND METHODS: Three sets of measures in 46 native AAA were obtained, double-blind by three radiologists (J, S, V) on orthogonal planes, curved multiplanar reconstructions, and semi-automated-software, based on the AAA-lumen centerline. From each set, the clinical decision was recorded as follows: "Follow-up" (if all diameters <50 mm), "ambiguous" (if at least one diameter <50 mm AND at least one ≥50 mm) or "Surgery " (if all diameters ≥50 mm). Intra- and interobserver agreements in clinical decisions were compared using the weighted Kappa coefficient.

RESULTS: Clinical decisions varied according to the measurement sets used by each observer, and according to intra and interobserver (lecture#1) reproducibility. Based on the first reading of each observer, the number of AAA proposed for surgery ranged from 11 to 24 for J, 5 to 20 for S, and 15 to 23 for V. The rate of AAAs classified as "ambiguous" varied from 11% (5/46) to 37% (17/46). The semi-automated method yielded very good intraand interobserver agreements in clinical decisions in all comparisons (Kappa range 0.83-1.00).

CONCLUSION: The semi-automated method seems to be appropriate for native AAA maximum diameter measurement on CTA. In the absence of AAA outer-wallbased software more robust for complex AAA, clinical decisions might best be made with diameter values obtained using this technique.

Keywords: Abdominal aortic aneurysm; Computed tomography; Reproducibility

Conflict of interest statement

Conflict of Interest:The authors have no conflict of interest relevant to this publication.

References

  1. Eur J Vasc Endovasc Surg. 2011 Jan;41 Suppl 1:S1-S58 - PubMed
  2. Eur J Radiol. 2012 Aug;81(8):1688-94 - PubMed
  3. J Vasc Surg. 2003 May;37(5):1106-17 - PubMed
  4. Eur J Vasc Endovasc Surg. 2014 Feb;47(2):139-50 - PubMed
  5. Lancet. 1986 Feb 8;1(8476):307-10 - PubMed
  6. Cardiovasc Intervent Radiol. 2012 Aug;35(4):779-87 - PubMed
  7. Cochrane Database Syst Rev. 2014 Jan 23;(1):CD004178 - PubMed
  8. BMJ. 2014 Jan 13;348:f7661 - PubMed
  9. Eur J Vasc Endovasc Surg. 2004 Apr;27(4):363-5 - PubMed
  10. Eur J Vasc Endovasc Surg. 2012 May;43(5):515-24 - PubMed
  11. Cardiovasc Intervent Radiol. 2013 Feb;36(1):14-24 - PubMed
  12. JAMA. 2013 Feb 27;309(8):806-13 - PubMed
  13. J Vasc Surg. 2004 Apr;39(4):811-5 - PubMed
  14. Eur J Vasc Endovasc Surg. 2004 Jul;28(1):28-35 - PubMed
  15. Eur J Vasc Endovasc Surg. 2013 Nov;46(5):525-32 - PubMed
  16. Eur J Radiol. 2011 Mar;77(3):502-8 - PubMed
  17. Eur J Vasc Endovasc Surg. 1996 Aug;12 (2):230-7 - PubMed

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