Two-dimensional versus three-dimensional CT angiography in analysis of anatomical suitability for stentgraft repair of XXXX .

@entity1 @entity439 @entity1028 @entity1072
BACKGROUND: The morphological analysis prior to endovascular @entity439 repair (EVAR) plays an important role in long-term outcomes. Post-imaging analysis of computed tomographic angiography (CTA) by three-dimensional reconstruction with central lumen line detection ( @entity1072 3D-CTA) enables measurements to be made in orthogonal slices. This might be more precise than equal post-imaging analysis in axial slices by two-dimensional computed tomographic angiography (2D-CTA). PURPOSE: To evaluate the intra- and interobserver variability of @entity1072 3D-CTA and 2D-CTA post-imaging analysis methods and the agreement between them in pre-EVAR suitability analysis of @entity1 with @entity1028 ( @entity1028 ). MATERIAL AND METHODS: Anonymized CTA data-sets from 70 @entity1 with @entity1028 were analyzed retrospectively. Length measurements included proximal and distal aortic neck lengths and total distance from the lower renal artery to the higher iliac bifurcation. Width measurements included proximal and distal neck diameters, maximum @entity1028 diameter and common iliac diameters just above the iliac bifurcations. The measurements were performed in random order by two vascular surgeons, twice per method with 1-month interval between readings. In the @entity1072 3D-CTA method we used semi-automated @entity1072 detection by software and manual measurements on CTA slices perpendicular to @entity1072 . The equal measurements in 2D-CTA were performed manually on axial CTA slices using a DICOM viewer workstation. The intra- and interobserver variability, as well as the agreement between the two methods were assessed by Bland-Altman test and bivariate correlation analysis. RESULTS: The intraobserver variability was significantly higher in 2D-CTA measurements for both readers. The interobserver variability was significant in 2D-CTA measurements of proximal neck dimensions while the agreement in @entity1072 3D-CTA analysis between the two readers was excellent in all studied parameters. The agreement between the two suitability analysis techniques was poor for both readers, especially in measurements of proximal neck's dimensions and in total aortoiliac length (p = 0.001). CONCLUSION: In pre-EVAR morphological evaluation of AAAs the @entity1072 -3D CTA post-imaging analysis has better intra- and interobserver correlation than 2D-CTA and might represent a useful tool for the proper selection of endograft's type and size.
