Applied research on the diagnosis and treatment of lower extremity arteriosclerosis obliterans with three-dimensional reconstruction using Mimics
袁鹏程 1冯永飞 1刘雪莹 1饶德新 1王丽萍
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作者信息
1. 河南大学第一附属医院心血管外科，开封 475000
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摘要
目的 评估基于Mimics三维重建对下肢动脉硬化闭塞症（LEASO）诊疗的有效性和准确性。 方法 收集河南大学第一附属医院心血管外科2020年1月至2023年3月70例LEASO患者的下肢动脉增强薄层CT及数字减影血管造影（DSA）检查资料，用Mimics软件进行下肢动脉及斑块三维建模，以CT血管造影（CTA）和DSA数据为参照，比较Mimics软件和DSA评估的动脉节段狭窄程度分级、中度及以上狭窄动脉诊断一致率、病变长度、支架直径、外周动脉钙化评分系统（PACSS）分级的情况，比较Mimics和CTA评估的钙化斑块体积、混合斑块钙化百分率的情况。 结果 与DSA结果相比，Mimics诊断动脉狭窄程度的符合率94.29%（792/840），高估率3.81%（32/840），低估率1.90%（16/840），其中对狭窄程度≥50%动脉节段诊断灵敏度为97.19%（311/320），特异度为98.08%（510/520），假阳性率为1.92%（10/520），假阴性率为2.81%（9/320），准确率为97.74%（821/840），Kappa值为0.952。Mimics和DSA对病变长度、支架直径的测量，差异无统计学意义（P>0.05）；Mimics和CTA对钙化斑块体积、混合斑块钙化百分率的测量，差异无统计学意义（P>0.05）。与DSA结果相比，Mimics对PACSS分级的判断符合率95.07%（135/142），高估率1.41%（2/142），低估率3.52%（5/142）。 结论 基于Mimics三维重建模型可直观地显示下肢动脉病变位置，并准确测量狭窄程度、病变长度、血管直径、斑块体积等，对LEASO术前精准诊疗具有指导意义。 Objective To establish a three-dimensional model of lower extremity arteriosclerosis obliterans (LEASO) using Mimics with data from computed tomography angiography (CTA) and digital subtraction angiography (DSA) and to evaluate the safety, effectiveness and accuracy of the diagnosis and treatment of the disease based on the established model. Methods From January 2020 to March 2023, the data of 70 patients with LEASO who underwent enhanced thin-slice CT and DSA examination of lower extremity arteries in the Department of Cardiovascular Surgery of the First Affiliated Hospital of Henan University were collected, and three-dimensional modeling of lower extremity arteries and plaques was performed by Mimics. The stenosis grading in artery segments, diagnostic agreement rate of diseased arteries, lesion length, stent diameter, and peripheral artery calification scoring system (PACSS) grade were compared between Mimics and DSA. The calcified plaque volume and the calcified proportion of mixed plaques were compared between Mimics and CTA. Results The diagnostic coincidence rate of Mimics was 94.29% (792/840) with 3.81% (32/840) of overestimation and 1.90% (16/840) of underestimation. For the arterial segments with a stenosis of at least 50%, the sensitivity (97.19%,311/320), specificity (98.08%,510/520), false positive rate (1.92%,10/520), false negative rate (2.81%,9/320), and accuracy (97.74%,821/840) were obtained. The Kappa coefficient was 0.952, suggesting almost perfect agreement. There was no significant difference in the measurement of lesion length and stent diameter between Mimics and DSA (both P>0.05). There was no significant difference in the measurement of calcified plaque volume and the calcified proportion of mixed plaques between Mimics and CTA (bothP>0.05). The coincidence rate of Mimics in PACSS grading was 95.07% (135/142) with 1.41% (2/142) of overestimation and 3.52% (5/142) of underestimation. Conclusion The three-dimensional reconstruction model based on Mimics can visually display the location of lower extremity arterial lesions, and accurately measure the degree of stenosis, lesion length, vessel diameter, plaque volume, etc., which are significant in accurate preoperative diagnosis and treatment of LEASO.
Abstract
Objective To establish a three-dimensional model of lower extremity arteriosclerosis obliterans (LEASO) using Mimics with data from computed tomography angiography (CTA) and digital subtraction angiography (DSA) and to evaluate the safety, effectiveness and accuracy of the diagnosis and treatment of the disease based on the established model. Methods From January 2020 to March 2023, the data of 70 patients with LEASO who underwent enhanced thin-slice CT and DSA examination of lower extremity arteries in the Department of Cardiovascular Surgery of the First Affiliated Hospital of Henan University were collected, and three-dimensional modeling of lower extremity arteries and plaques was performed by Mimics. The stenosis grading in artery segments, diagnostic agreement rate of diseased arteries, lesion length, stent diameter, and peripheral artery calification scoring system (PACSS) grade were compared between Mimics and DSA. The calcified plaque volume and the calcified proportion of mixed plaques were compared between Mimics and CTA. Results The diagnostic coincidence rate of Mimics was 94.29% (792/840) with 3.81% (32/840) of overestimation and 1.90% (16/840) of underestimation. For the arterial segments with a stenosis of at least 50%, the sensitivity (97.19%,311/320), specificity (98.08%,510/520), false positive rate (1.92%,10/520), false negative rate (2.81%,9/320), and accuracy (97.74%,821/840) were obtained. The Kappa coefficient was 0.952, suggesting almost perfect agreement. There was no significant difference in the measurement of lesion length and stent diameter between Mimics and DSA (both P>0.05). There was no significant difference in the measurement of calcified plaque volume and the calcified proportion of mixed plaques between Mimics and CTA (bothP>0.05). The coincidence rate of Mimics in PACSS grading was 95.07% (135/142) with 1.41% (2/142) of overestimation and 3.52% (5/142) of underestimation. Conclusion The three-dimensional reconstruction model based on Mimics can visually display the location of lower extremity arterial lesions, and accurately measure the degree of stenosis, lesion length, vessel diameter, plaque volume, etc., which are significant in accurate preoperative diagnosis and treatment of LEASO.
关键词
动脉硬化闭塞症/Mimics/三维模型
Key words
Arteriosclerosis obliterans/Mimics/Three-dimensional model
万方数据