目的:验证Galen动脉瘤畸形(VGAM)分割静脉的半自动方法,并评估VGAM体积与其他血管结构特征之间的关系,心脏病学发现,和结果。
方法:在这项回顾性研究中,我们选择了2009年至2022年间Gaslini儿童医院收治的所有VGAM患者。从电子图表中检索临床数据。我们将两名独立观察者使用相衬MR静脉造影获得的3D-Slicer分割的VGAM体积与对T2加权图像进行手动测量获得的体积进行了比较。然后探索VGAM体积与临床和神经影像学特征之间的关系。
结果:43名患有VGAM的受试者(22名男性,平均年龄6.56天)纳入研究。手动和半自动VGAM体积对于两个读取器都很好地相关(分别为r=0.86和0.82)。关于再现性,手动方法的评分者类别间相关系数为0.885,半自动方法为0.992(p<0.001)。对于半自动方法,重复测量的标准误差较低(0.04对手动方法的0.40)。较高的VGAM体积与上矢状窦狭窄有关,颈静脉球狭窄,和水管狭窄(p<0.05)。VGAM体积与直窦扩张(r=0.331)和上矢状窦指数(r=-0.325)之间存在弱相关性。与心脏检查结果没有显著关联,栓塞后并发症,和结果(p>0.05)。
结论:与手动方法相比,半自动VGAM容积测定法是可行和可靠的,具有改进的可重复性。VGAM体积不是临床结果的预后因素,但它与其他具有潜在血流动力学影响的静脉发现有关。
OBJECTIVE: To validate a semiautomated method for segmenting vein of Galen aneurysmal malformations (VGAM) and to assess the relationship between VGAM volume and other angioarchitectural features, cardiological findings, and outcomes.
METHODS: In this retrospective study, we selected all subjects with VGAM admitted to the Gaslini Children\'s Hospital between 2009 and 2022. Clinical data were retrieved from electronic charts. We compared 3D-Slicer segmented VGAM volumes obtained by two independent observers using phase-contrast MR venography to those obtained with manual measurements performed on T2-weighted images. The relationship between VGAM volumes and clinical and neuroimaging features was then explored.
RESULTS: Forty-three subjects with VGAM (22 males, mean age 6.56 days) were included in the study. Manual and semiautomated VGAM volumes were well correlated for both readers (r = 0.86 and 0.82, respectively). Regarding reproducibility, the inter-rater interclass correlation coefficients were 0.885 for the manual method and 0.992 for the semiautomated method (p < 0.001). The standard error for repeated measures was lower for the semiautomated method (0.04 versus 0.40 of manual method). Higher VGAM volume was associated with superior sagittal sinus narrowing, jugular bulb stenosis, and aqueductal stenosis (p < 0.05). A weak correlation was found between VGAM volume and straight sinus dilatation (r = 0.331) and superior sagittal sinus index (r = - 0.325). No significant associations were found with cardiac findings, post-embolization complications, and outcome (p > 0.05).
CONCLUSIONS: Semiautomated VGAM volumetry is feasible and reliable with improved reproducibility compared to the manual method. VGAM volume is not a prognostic factor for clinical outcome, but it is related to other venous findings with potential hemodynamic effects.