Centerline Analysis of Aortic CT Angiographic Examinations: Benefits and Limitations

Abstract

Semiautomatic centerline analysis is beneficial for the assessment of aortic geometry and allows precise measurements of aortic diameters and lengths. It can be simple, fast, and reproducible, but it should be used with care considering its inherent limitations. Manually adjusted multiplanar reformations remain an essential tool for intuitive visualization of the vascular anatomy.

Impact of Oversizing on the Risk of Retrograde Dissection After TEVAR for Acute and Chronic Type B Dissection

“…The multiplanar reformation method conventionally used in the preoperative measurement of oversizing requires that the diameter be measured at the same position at different levels to guarantee the results are most comprehensive and accurate. 18 Although it is not accurate, physicians for convenience often take the measurement in a single dimension using the diameter of the landing site. Thus, the centerline of flow method was used in this study to ensure the real diameter of the aorta was measured.…”

Complications after aortic arch hybrid repair

“…Whenever available, stent graft sizing was based on preoperative centerline measurements. 8 Follow-up. The follow-up protocol included postoperative CTA before discharge, clinical examination, plain chest radiography and CTA/MRA 6 and 12 months postoperatively and annually thereafter.…”

Proximal thoracic aortic diameter measurements at CT: repeatability and reproducibility according to measurement method

“…For each patient, this entire procedure was repeated by each radiologist, including the creation of new double-oblique reconstructions; an interval of at least two weeks between measurement sessions was used to assure lack of recall bias when remeasuring. Secondly, measurements at the same aortic locations were obtained in the department’s 3D lab by a single experienced CT technologist using standard semiautomatic centerline analysis [1] on an independent workstation (Advantage Windows workstations, software version 4.5, GE Healthcare, Milwaukee, WI); outer aortic wall contours were adjusted by the technologist, as necessary, in order to include the wall and exclude adjacent structures. The same measurements were repeated by the same technologist at least two weeks later, using newly generated centerline analysis images.…”

“…Measurements may be obtained using different methods, including manual diameters from axial images and double-oblique short axis views and semiautomatic diameters from 3D centerline analysis [1] [2]. It has been shown that the use of axial images leads to overestimation of aortic size at the root and sinotubular junction, potentially impacting surgical decision making [2].…”