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Abstract：
There is no standard for measuring maximal diameter (Dmax) of abdominal aortic aneurysm (AAA) from computer tomography (CT) images although differences between Dmax evaluated from transversal (axialDmax) or orthogonal (orthoDmax) planes can be large especially for angulated AAAs. Therefore we investigated their correlations with alternative rupture risk indicators as peak wall stress (PWS) and peak wall rupture risk (PWRR) to decide which Dmax is more relevant in AAA rupture risk assessment.
The Dmax values were measured by a trained radiologist from 70 collected CT scans, and the corresponding PWS and PWRR were evaluated using Finite Element Analysis (FEA). The cohort was ordered according to the difference between axialDmax and orthoDmax (Da-o) quantifying the aneurysm angulation, and Spearman\'s correlation coefficients between PWS/PWRR - orthoDmax/axialDmax were calculated.
The calculated correlations PWS/PWRR vs. orthoDmax were substantially higher for angulated AAAs (with Da-o≥3mm). Under this limit, the correlations were almost the same for both Dmax values. Analysis of AAAs divided into two groups of angulated (n=38) and straight (n=32) cases revealed that both groups are similar in all parameters (orthoDmax, PWS, PWRR) with the exception of axialDmax (p=0.024).
It was confirmed that orthoDmax is better correlated with the alternative rupture risk predictors PWS and PWRR for angulated AAAs (DA-O≥3mm) while there is no difference between orthoDmax and axialDmax for straight AAAs (DA-O<3mm). As angulated AAAs represent a significant portion of cases it can be recommended to use orthoDmax as the only Dmax parameter for AAA rupture risk assessment.
The Dmax values were measured by a trained radiologist from 70 collected CT scans, and the corresponding PWS and PWRR were evaluated using Finite Element Analysis (FEA). The cohort was ordered according to the difference between axialDmax and orthoDmax (Da-o) quantifying the aneurysm angulation, and Spearman\'s correlation coefficients between PWS/PWRR - orthoDmax/axialDmax were calculated.
The calculated correlations PWS/PWRR vs. orthoDmax were substantially higher for angulated AAAs (with Da-o≥3mm). Under this limit, the correlations were almost the same for both Dmax values. Analysis of AAAs divided into two groups of angulated (n=38) and straight (n=32) cases revealed that both groups are similar in all parameters (orthoDmax, PWS, PWRR) with the exception of axialDmax (p=0.024).
It was confirmed that orthoDmax is better correlated with the alternative rupture risk predictors PWS and PWRR for angulated AAAs (DA-O≥3mm) while there is no difference between orthoDmax and axialDmax for straight AAAs (DA-O<3mm). As angulated AAAs represent a significant portion of cases it can be recommended to use orthoDmax as the only Dmax parameter for AAA rupture risk assessment.
摘要：
没有从计算机断层扫描（CT）图像测量腹主动脉瘤（AAA）的最大直径（Dmax）的标准，尽管从横向（axialDmax）或正交（orthoDmax）平面评估的Dmax之间的差异可能很大，尤其是对于成角度的AAA。因此，我们调查了它们与其他破裂风险指标的相关性，如峰值壁应力（PWS）和峰值壁破裂风险（PWRR），以确定哪个Dmax在AAA破裂风险评估中更相关。
Dmax值由受过训练的放射科医生从收集的70次CT扫描中测量，使用有限元分析（FEA）评估相应的PWS和PWRR。根据axialDmax和orthoDmax（Da-o）之间的差异对该队列进行排序，以量化动脉瘤角度，计算了PWS/PWRR-orthoDmax/axialDmax之间的Spearman相关系数。
计算的相关性PWS/PWRR与成角度的AAAs（Da-o≥3mm）的orthoDmax明显更高。在这个限制下,两个Dmax值的相关性几乎相同.将AAAs分为成角度（n=38）和直（n=32）两组病例的分析显示，两组在所有参数上都相似（orthoDmax，PWS,PWRR)，axialDmax(p=0.024)除外。
已证实，对于成角度的AAAs（DA-O≥3mm），orthoDmax与替代破裂风险预测因子PWS和PWRR的相关性更好，而对于直AAAs（DA-O<3mm），orthoDmax与axialDmax之间没有差异。由于成角度的AAAs代表了很大一部分病例，因此可以建议使用orthoDmax作为AAA破裂风险评估的唯一Dmax参数。
Dmax值由受过训练的放射科医生从收集的70次CT扫描中测量，使用有限元分析（FEA）评估相应的PWS和PWRR。根据axialDmax和orthoDmax（Da-o）之间的差异对该队列进行排序，以量化动脉瘤角度，计算了PWS/PWRR-orthoDmax/axialDmax之间的Spearman相关系数。
计算的相关性PWS/PWRR与成角度的AAAs（Da-o≥3mm）的orthoDmax明显更高。在这个限制下,两个Dmax值的相关性几乎相同.将AAAs分为成角度（n=38）和直（n=32）两组病例的分析显示，两组在所有参数上都相似（orthoDmax，PWS,PWRR)，axialDmax(p=0.024)除外。
已证实，对于成角度的AAAs（DA-O≥3mm），orthoDmax与替代破裂风险预测因子PWS和PWRR的相关性更好，而对于直AAAs（DA-O<3mm），orthoDmax与axialDmax之间没有差异。由于成角度的AAAs代表了很大一部分病例，因此可以建议使用orthoDmax作为AAA破裂风险评估的唯一Dmax参数。
