Reproducibility of ultrasound measurement of the abdominal aorta

Beales, Lucy; Wolstenhulme, Stephen; Evans, JA; West, Robert; Scott, Daniel

doi:10.1002/bjs.7628

Cited by 123 publications

(85 citation statements)

References 38 publications

(117 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…4,6 With ultrasound, measurements within the anteroposterior, rather than the transverse plane, have been reported to be more reproducible. 4 There is no current consensus on how to place the calipers when measuring the diameter with ultrasound. Methods used include the outer-to-outer method, where calipers are placed on the outer layer of the aortic wall; the inner-to-inner method, where calipers are placed on the inner layer of the aortic wall; and the leading edge-to-leading edge method, where calipers are placed on the outer layer of the anterior wall and the inner layer of the posterior wall ( Figure 1).…”

Section: Wanhainen Et Al Surrogate Markers Of Aneurysm Progression 237mentioning

confidence: 99%

“…Because of its ease of use, safety, wide availability, and low cost, ultrasound is the most commonly used imaging modality for large-scale screening and monitoring of small AAAs. Although ultrasound is an excellent technique for this purpose, an intra-and interobserver variabilities (2 SDs) in the range of 2 to 7 mm and 2 to 10 mm, respectively, 4,5 represent an important limitation that may have significant impact on clinical decision making. Modern computed tomography (CT) and magnetic resonance imaging (MRI) with advanced image processing methods, such as multiplanar reformation, are perceived to have higher accuracy and reproducibility, with a reported intra-and interobserver variability of <2 mm.…”

Section: Aaa Diametermentioning

confidence: 99%

See 1 more Smart Citation

Surrogate Markers of Abdominal Aortic Aneurysm Progression

Wanhainen

Mani

Golledge

2016

ATVB

View full text Add to dashboard Cite

Abstract-The natural course of many abdominal aortic aneurysms (AAA) is to gradually expand and eventually rupture and monitoring the disease progression is essential to their management. In this publication, we review surrogate markers of AAA progression. AAA diameter remains the most widely used and important marker of AAA growth. Wanhainen et al Surrogate Markers of Aneurysm Progression 237in all studies when a standardized protocol is used. 7,8 One of the challenging aspects to assessing maximum AAA diameter is the variety of methods that can potentially be used and the lack of reporting of the exact techniques used in individual studies. Variations may occur in the plane of acquisition (eg, coronal or sagittal), the axis of measurement (eg, axial or orthogonal), the position of the measuring calipers (eg, inner to inner or outer to outer), the relationship with the cardiac cycle (systole versus diastole), and the selected region of the AAA. 9 It has been suggested that diameters measured perpendicular to the aorta centerline (orthogonal), rather than within the axial plane, are more representative of the true AAA diameter. 4,6 With ultrasound, measurements within the anteroposterior, rather than the transverse plane, have been reported to be more reproducible. 4 There is no current consensus on how to place the calipers when measuring the diameter with ultrasound. Methods used include the outer-to-outer method, where calipers are placed on the outer layer of the aortic wall; the inner-to-inner method, where calipers are placed on the inner layer of the aortic wall; and the leading edge-to-leading edge method, where calipers are placed on the outer layer of the anterior wall and the inner layer of the posterior wall ( Figure 1). Much of the reported variation in ultrasound measured AAA diameter is likely because of the variation in caliper placement. 5,10 The UK Small Aneurysm Trial 11 is based on the measurement of AAA diameter on the outer-to-outer method, and this method has been adopted into the current UK intervention criteria. 12 The inner-to-inner method was used in the Multicentre Aneurysm Screening Study, 13 and consequently it is used in the current UK National Health Service AAA screening programme.14 The leading edgeto-leading edge method is used in the current Swedish AAA screening programme.15 Studies comparing these methods show there is a significant difference in diameters measured with the different methods, which has an impact on the reported prevalence rates of AAA. 5,10 In a Swedish AAA screening study, the difference in mean diameter was 4 mm between inner-toinner and outer-to-outer, which resulted in an astonishing 77% difference in AAA prevalence (ie, 1.3% compared with 2.3%). 5A systematic review of 15 studies reported considerable variation in small AAA growth rates (mean, −0.3 to +4.0 mm/y). 15 The variation could not be explained by differences in initial AAA diameter alone. 16 The authors suggested that methodological issues, such as differences in imaging modalities, variation ...

show abstract

Section: Wanhainen Et Al Surrogate Markers Of Aneurysm Progression 237mentioning

confidence: 99%

Section: Aaa Diametermentioning

confidence: 99%

Surrogate Markers of Abdominal Aortic Aneurysm Progression

Wanhainen

Mani

Golledge

2016

ATVB

View full text Add to dashboard Cite

show abstract

“…10 Ultrasound is highly operator dependent, and inter-and intraobserver variability does exist. [9][10][11][12][13][14] The aorta diameter measured in the anteroposterior (AP) plane is reproduced more accurately compared to that measured in the transverse (TR) plane. 10 Three approaches exist for measurement of the aorta diameter with ultrasound: inner-to-inner (ITI), leading-edge-toleading edge and outer-to-outer (OTO), as shown in Figure 2.…”

mentioning

confidence: 99%

“…10 Three approaches exist for measurement of the aorta diameter with ultrasound: inner-to-inner (ITI), leading-edge-toleading edge and outer-to-outer (OTO), as shown in Figure 2. 9 In the ITI approach, the calipers of the aorta diameter are measured from the anterior inner lumen of the aorta wall to the posterior inner lumen of the aorta wall. In the leadingedge-to-leading edge approach, the calipers are placed on the outer layer of the anterior aorta wall and measured to the inner lumen of the posterior wall.…”

mentioning

confidence: 99%

“…13,17,20 The Screening Abdominal Aortic Aneurysm Very Efficiently program in the USA refers to the OTO technique to screen for aneurysms. 9,21 The American Institute of Ultrasound in Medicine and the American College of Emergency Physicians both recommend the OTO method. The American College of Emergency Physicians further recommends that both the AP and TR (side-to-side) aorta diameters should be measured in the axial planes when feasible.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Overview of common errors and pitfalls to avoid in the acquisition and interpretation of ultrasound imaging of the abdominal aorta

Lema¹,

Kim²,

James³

2017

JVD

View full text Add to dashboard Cite

Abdominal aortic aneurysms (AAAs) occur when the aorta diameter is >3 cm (30 mm). Ruptured AAA has a high mortality rate. Ultrasound is the imaging modality of choice to screen for this vascular disease. There are many common errors and pitfalls in the acquisition and interpretation of ultrasound imaging of the abdominal aorta, such as measurement errors and variations in technique, misdiagnosis errors, difficulty with visualization of the aorta and a wide range of sonographer experience. We review the common errors and pitfalls to recognize and avoid in ultrasound imaging of the abdominal aorta.

show abstract

Ultrasonography for endoleak detection after endoluminal abdominal aortic aneurysm repair

Abraha¹,

Luchetta

Florio³

et al. 2017

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

Background People with abdominal aortic aneurysm who receive endovascular aneurysm repair (EVAR) need lifetime surveillance to detect potential endoleaks. Endoleak is defined as persistent blood flow within the aneurysm sac following EVAR. Computed tomography (CT) angiography is considered the reference standard for endoleak surveillance. Colour duplex ultrasound (CDUS) and contrast-enhanced CDUS (CE-CDUS) are less invasive but considered less accurate than CT. Objectives To determine the diagnostic accuracy of colour duplex ultrasound (CDUS) and contrast-enhanced-colour duplex ultrasound (CE-CDUS) in terms of sensitivity and specificity for endoleak detection after endoluminal abdominal aortic aneurysm repair (EVAR). Search methods We searched MEDLINE, Embase, LILACS, ISI Conference Proceedings, Zetoc, and trial registries in June 2016 without language restrictions and without use of filters to maximize sensitivity. Selection criteria Any cross-sectional diagnostic study evaluating participants who received EVAR by both ultrasound (with or without contrast) and CT scan assessed at regular intervals. Data collection and analysis Two pairs of review authors independently extracted data and assessed quality of included studies using the QUADAS 1 tool. A third review author resolved discrepancies. The unit of analysis was number of participants for the primary analysis and number of scans performed for the secondary analysis. We carried out a meta-analysis to estimate sensitivity and specificity of CDUS or CE-CDUS using a bivariate model. We analysed each index test separately. As potential sources of heterogeneity, we explored year of publication, characteristics of included participants (age and gender), direction of the study (retrospective, prospective), country of origin, number of CDUS operators, and ultrasound manufacturer. Ultrasonography for endoleak detection after endoluminal abdominal aortic aneurysm repair (Review)

show abstract

Reproducibility of ultrasound measurement of the abdominal aorta

Cited by 123 publications

References 38 publications

Surrogate Markers of Abdominal Aortic Aneurysm Progression

Surrogate Markers of Abdominal Aortic Aneurysm Progression

Overview of common errors and pitfalls to avoid in the acquisition and interpretation of ultrasound imaging of the abdominal aorta

Ultrasonography for endoleak detection after endoluminal abdominal aortic aneurysm repair

Contact Info

Product

Resources

About