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

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

doi:10.13406/j.cnki.cyxb.003562

您当前的位置：

首页 >

文章列表页 >

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

Medical imaging | 更新时间：2025-10-21

- Comparison of CT image post-processing methods for the accuracy of morphological measurement of intracranial aneurysms
- Journal of Chongqing Medical University Vol. 49, Issue 8, Pages: 1052-1057(2024)
- 作者机构：
  
  1.重庆医科大学附属第一医院放射科，重庆 400016
  2.昆明医科大学第一附属医院影像科，昆明 650032
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.003562
  CLC：
- Received：03 December 2023，
  
  Revised：2024-01-10，
  
  Accepted：04 February 2024，
  
  Published：28 August 2024
- 稿件说明：
移动端阅览
吴钖莹,张丽娟,康绍磊,等.CT图像后处理方法对颅内动脉瘤形态学参数测量准确性的影响[J].重庆医科大学学报,2024,49(8):1052-1057.

Wu Yangying,Zhang Lijuan,Kang Shaolei,et al.Comparison of CT image post-processing methods for the accuracy of morphological measurement of intracranial aneurysms[J].Journal of Chongqing Medical University,2024,49(8):1052-1057.
吴钖莹,张丽娟,康绍磊,等.CT图像后处理方法对颅内动脉瘤形态学参数测量准确性的影响[J].重庆医科大学学报,2024,49(8):1052-1057. DOI： 10.13406/j.cnki.cyxb.003562.

Wu Yangying,Zhang Lijuan,Kang Shaolei,et al.Comparison of CT image post-processing methods for the accuracy of morphological measurement of intracranial aneurysms[J].Journal of Chongqing Medical University,2024,49(8):1052-1057. DOI： 10.13406/j.cnki.cyxb.003562.

摘要

目的

以三维数字减影血管造影（three-dimensional digital subtraction angiography，3D-DSA）为“金标准”，基于CT血管成像（CT angiography，CTA）对比最大密度投影（maximum intensity projection，MIP）联合多平面重组（multiplanar reconstruction，MPR）和减影的容积再现（volume rendering，VR）这2种图像后处理方法之间颅内动脉瘤形态学参数测量结果的差异。

方法

回顾性分析重庆医科大学附属第一医院92例（共116个颅内未破裂动脉瘤）患者的头颈CTA和DSA影像资料。使用双盲法分别在3D-DSA的VR、CTA的MIP-MPR和减影VR图像上测量动脉瘤的形态学参数，测量2次取均值，并计算相关的形态学衍生指标。使用组内相关系数（intraclass correlation coefficient，ICC）比较观察者间测量值的一致性，利用重复测量的方差分析或Friedman秩和检验比较不同后处理图像上测量结果的差异，后续组间两两比较采用Bonferroni校正。采用卡方检验对比各组小、微小动脉瘤及宽颈动脉瘤的分布情况。

结果

基于MIP

-MPR、减影VR和3D-DSA测得的动脉瘤最大径、瘤宽和瘤高在三组间整体比较时差异无统计学意义（

２

值分别为4.484、5.808、4.468，均

0.05）；而得到的颈宽、载瘤动脉的平均直径在三组间整体比较时差异有统计学意义（

２

值分别为48.341、87.948，均

0.001）；进行后续的组间两两比较时结果存在差异，且这种差异在颈内动脉虹吸部与非虹吸部2个亚组内又有一定区别。由MIP-MPR得出的形态学衍生指标均偏大，与DSA相比差异均有统计学意义（

0.017），除高宽比外，与减影VR相比差异也有统计学意义（

0.017）。基于减影VR进行动脉瘤的形态学评估，仅载瘤动脉的平均直径和大小比与DSA相比差异有统计学意义（

0.017），但载瘤动脉的平均直径测量差异在亚组分析时不明显（

0.017）；其余参数与DSA相比差异均无统计学意义（

0.017）。

结论

减影VR上颅内动脉瘤形态学参数测量的准确性优于MIP-MPR，更适用于颈内动脉虹吸部动脉瘤的形态学评估。

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（

２

=4.484，5.808，and 4.468 respectively，all

0.05）. The neck width and the mean diameter of the parent artery differed significantly among the three groups overall（

２

=48.341，87.948，both

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（

0.017），and also significantly different compared with subtracted VR except for the height-to-width ratio（

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（

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.

关键词

Keywords

references

Etminan N ， MacDonald RL . Neurovascular disease，diagnosis，and therapy：subarachnoid hemorrhage and cerebral vasospasm [J ] . Handb Clin Neurol ， 2021 ， 176 ： 135 - 169 ．

Wang GX ， Liu J ， Chen YQ ， et al . Morphological characteristics associated with the rupture risk of mirror posterior communicating artery aneurysms [J ] . J Neurointerv Surg ， 2018 ， 10 （ 10 ）： 995 - 998 ．

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， 2022 ， 28 （ 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 Imag ， 2022 ， 28 （ 1 ）： 26 - 31 ．

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， 2021 ， 18 （ 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 Dis ， 2021 ， 18 （ 7 ）： 492 - 504 .

Dhar S ， Tremmel M ， Mocco J ， et al . Morphology parameters for intracranial aneurysm rupture risk assessment [J ] . Neurosurgery ， 2008 ， 63 （ 2 ）： 185 - 196 .

Rajabzadeh-Oghaz H ， Varble N ， Shallwani H ， et al . Computer-assisted three-dimensional morphology evaluation of intracranial aneurysms [J ] . World Neurosurg ， 2018 ， 119 ： 541 - 550 ．

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 Surg ， 2020 ， 15 （ 10 ）： 1749 - 1759 ．

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， 2019 ， 16 （ 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 Dis ， 2019 ， 16 （ 12 ）： 633 - 636 ．

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 ] . Neuroradiology ， 2017 ， 59 （ 5 ）： 491 - 497 ．

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， 2017 ， 14 （ 21 ）： 3189 - 3190，3192 ．

Jiang YM . Application value of MSCTA image post-processing technique in intracranial aneurysms [J ] . Lab Med Clin ， 2017 ， 14 （ 21 ）： 3189 - 3190，3192 ．

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， 2022 ， 20 （ 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 MRI ， 2022 ， 20 （ 1 ）： 18 - 20 ．

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 Neuroradiol ， 1994 ， 15 （ 5 ）： 815 - 820 ．

Vinacci G ， Celentano A ， Agosti E ， et al . Comaneci-assisted coiling of wide-necked intracranial aneurysm：a single-center preliminary experience [J ] . J Clin Med ， 2022 ， 11 （ 22 ）： 6650 ．

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 Neuroradiol ， 2012 ， 33 （ 8 ）： 1475 - 1480 ．

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 Neurochir ， 2017 ， 159 （ 7 ）： 1313 - 1319 ．

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 ．

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 Neurol ， 2021 ， 12 ： 693549 ．

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

No data

Related Author

Wang Yuan

Zhang Ming

Bu Gang

Li Dan

He Zhaohui

Huang Hao

Zhao Jun

He Zhaohui

Related Institution

Department of Respiratory and Critical Care Medicine,the First Affliated Hospital of Xi’an Jiaotong University

Department of Pain,the First Affliated Hospital of Xi’an Jiaotong University

Department of Medical Imaging,the First Affliated Hospital of Xi’an Jiaotong University

Department of Neurosurgery,The First Affiliated Hospital of Chongqing Medical University

⁰