Is ultrasound more accurate than axial computed tomography for determination of maximal abdominal aortic aneurysm diameter?

Larry Richard Sprouse, G. H. Meier, F. N. Parent, R. J. DeMasi, M. H. Glickman, G. A. Barber

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

Objective(s). Clinical assessment of maximal abdominal aortic aneurysm (AAA) diameter assumes clinical equivalency between ultrasound (US) and axial computed tomography (CT). Three-dimensional (3D) CT reconstruction allows for the assessment of AAA in the orthogonal plane and avoids oblique cuts due to AAA angulation. This study was undertaken to compare maximal AAA diameter by US, axial CT, and orthogonal CT, and to assess the effect that AAA angulation has on each measurement. Methods. Maximal AAA diameter by US (USmax), axial CT (axialmax), and orthogonal CT (orthogonalmax) along with aortic angulation and minor axis diameters were measured prospectively. Spiral CT data was processed by Medical Media Systems (West Lebanon, NH) to produce computerized axial CT and reformatted orthogonal CT images. The US technologists were blinded to all CT results and vice versa. Results. Thirty-eight patients were analyzed. Mean axialmax (58.0 mm) was significantly larger (P <0.05) than USmax (53.9 mm) or orthogonalmax (54.7 mm). The difference between USmax and orthogonalmax (0.8 mm) was insignificant ( P >0.05). When aortic angulation was ≤25°, axialmax (55.3 mm), USmax (54.3 mm), and orthogonalmax (54.1 mm) were similar (P >0.05); however, when aortic angulation was >25°, axialmax (60.1 mm) was significantly larger (P <0.001) than USmax (53.8 mm) and orthogonal max (55.0 mm). The limits of agreement (LOA) between axialmax and both USmax and orthogonal max was poor and exceeded clinical acceptability (±5 mm). The variation between USmax and orthogonalmax was minimal with an acceptable LOA of -2.7 to 4.5 mm. Conclusion. Compared to axial CT, US is a better approximation of true perpendicular AAA diameter as determined by orthogonal CT. When aortic angulation is greater than 25° axial CT becomes unreliable. However, US measurements are not affected by angulation and agree strongly with orthogonal CT measurements.

Original languageEnglish (US)
Pages (from-to)28-35
Number of pages8
JournalEuropean Journal of Vascular and Endovascular Surgery
Volume28
Issue number1
DOIs
StatePublished - Jul 1 2004
Externally publishedYes

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Abdominal Aortic Aneurysm
Tomography
Lebanon
Therapeutic Equivalency
Spiral Computed Tomography

All Science Journal Classification (ASJC) codes

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Is ultrasound more accurate than axial computed tomography for determination of maximal abdominal aortic aneurysm diameter? / Sprouse, Larry Richard; Meier, G. H.; Parent, F. N.; DeMasi, R. J.; Glickman, M. H.; Barber, G. A.

In: European Journal of Vascular and Endovascular Surgery, Vol. 28, No. 1, 01.07.2004, p. 28-35.

Research output: Contribution to journalArticle

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abstract = "Objective(s). Clinical assessment of maximal abdominal aortic aneurysm (AAA) diameter assumes clinical equivalency between ultrasound (US) and axial computed tomography (CT). Three-dimensional (3D) CT reconstruction allows for the assessment of AAA in the orthogonal plane and avoids oblique cuts due to AAA angulation. This study was undertaken to compare maximal AAA diameter by US, axial CT, and orthogonal CT, and to assess the effect that AAA angulation has on each measurement. Methods. Maximal AAA diameter by US (USmax), axial CT (axialmax), and orthogonal CT (orthogonalmax) along with aortic angulation and minor axis diameters were measured prospectively. Spiral CT data was processed by Medical Media Systems (West Lebanon, NH) to produce computerized axial CT and reformatted orthogonal CT images. The US technologists were blinded to all CT results and vice versa. Results. Thirty-eight patients were analyzed. Mean axialmax (58.0 mm) was significantly larger (P <0.05) than USmax (53.9 mm) or orthogonalmax (54.7 mm). The difference between USmax and orthogonalmax (0.8 mm) was insignificant ( P >0.05). When aortic angulation was ≤25°, axialmax (55.3 mm), USmax (54.3 mm), and orthogonalmax (54.1 mm) were similar (P >0.05); however, when aortic angulation was >25°, axialmax (60.1 mm) was significantly larger (P <0.001) than USmax (53.8 mm) and orthogonal max (55.0 mm). The limits of agreement (LOA) between axialmax and both USmax and orthogonal max was poor and exceeded clinical acceptability (±5 mm). The variation between USmax and orthogonalmax was minimal with an acceptable LOA of -2.7 to 4.5 mm. Conclusion. Compared to axial CT, US is a better approximation of true perpendicular AAA diameter as determined by orthogonal CT. When aortic angulation is greater than 25° axial CT becomes unreliable. However, US measurements are not affected by angulation and agree strongly with orthogonal CT measurements.",
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N2 - Objective(s). Clinical assessment of maximal abdominal aortic aneurysm (AAA) diameter assumes clinical equivalency between ultrasound (US) and axial computed tomography (CT). Three-dimensional (3D) CT reconstruction allows for the assessment of AAA in the orthogonal plane and avoids oblique cuts due to AAA angulation. This study was undertaken to compare maximal AAA diameter by US, axial CT, and orthogonal CT, and to assess the effect that AAA angulation has on each measurement. Methods. Maximal AAA diameter by US (USmax), axial CT (axialmax), and orthogonal CT (orthogonalmax) along with aortic angulation and minor axis diameters were measured prospectively. Spiral CT data was processed by Medical Media Systems (West Lebanon, NH) to produce computerized axial CT and reformatted orthogonal CT images. The US technologists were blinded to all CT results and vice versa. Results. Thirty-eight patients were analyzed. Mean axialmax (58.0 mm) was significantly larger (P <0.05) than USmax (53.9 mm) or orthogonalmax (54.7 mm). The difference between USmax and orthogonalmax (0.8 mm) was insignificant ( P >0.05). When aortic angulation was ≤25°, axialmax (55.3 mm), USmax (54.3 mm), and orthogonalmax (54.1 mm) were similar (P >0.05); however, when aortic angulation was >25°, axialmax (60.1 mm) was significantly larger (P <0.001) than USmax (53.8 mm) and orthogonal max (55.0 mm). The limits of agreement (LOA) between axialmax and both USmax and orthogonal max was poor and exceeded clinical acceptability (±5 mm). The variation between USmax and orthogonalmax was minimal with an acceptable LOA of -2.7 to 4.5 mm. Conclusion. Compared to axial CT, US is a better approximation of true perpendicular AAA diameter as determined by orthogonal CT. When aortic angulation is greater than 25° axial CT becomes unreliable. However, US measurements are not affected by angulation and agree strongly with orthogonal CT measurements.

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