Measurement of abdominal aortic aneurysms with three-dimensional ultrasound imaging: Preliminary report Daniel F. Leotta, PhD, Marla Paun, BS, Kirk W.

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Measurement of abdominal aortic aneurysms with three-dimensional ultrasound imaging: Preliminary report Daniel F. Leotta, PhD, Marla Paun, BS, Kirk W. Beach, PhD, MD, Ted R. Kohler, MD, R.Eugene Zierler, MD, D.Eugene Strandness, MD Journal of Vascular Surgery Volume 33, Issue 4, Pages 700-707 (April 2001) DOI: 10.1067/mva.2001.112812 Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 1 Block diagram of 3-D ultrasound imaging system. Position and orientation of the scanhead in space are measured by magnetic tracking system. Magnetic field generator is mounted beneath a wooden examination bed, while the sensor is attached to standard ultrasound scanhead. Acquisition of ultrasound video output and the spatial tracking data is initiated by a hand switch and ECG trigger signal. Data reconstruction, visualization, and analysis are performed on Unix workstation after completion of imaging study. ECG, Electrocardiogram. Journal of Vascular Surgery 2001 33, 700-707DOI: (10.1067/mva.2001.112812) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 2 Schematic of data acquisition and reconstruction steps. A, The aorta is scanned in cross section; scanhead location is tracked by an attached magnetic receiver. B, A series of cross-sectional images are saved with their corresponding position and orientation data. C, The borders of aorta are traced on each of the images. D, The outlines are registered in 3-D coordinates, and a surface is constructed. Journal of Vascular Surgery 2001 33, 700-707DOI: (10.1067/mva.2001.112812) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 3 Surface display of 3-D reconstruction of normal aorta. A portion of the superior mesenteric artery (SMA ) is also included in the reconstruction. Diamond markers show origins of renal arteries. Journal of Vascular Surgery 2001 33, 700-707DOI: (10.1067/mva.2001.112812) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 4 Surface display of 3-D reconstruction of an AAA. Diamond markers show origins of renal arteries and the SMA. SMA, Superior mesenteric artery. Journal of Vascular Surgery 2001 33, 700-707DOI: (10.1067/mva.2001.112812) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 5 Measurements derived from 3-D reconstruction of AAA shown in Fig 4. a, Surface display in which the color of surface represents cross-sectional area of vessel. Color scale is shown at the right , with the equivalent diameter assuming a circular cross section included for reference. b, Color-coded mesh showing center axis connecting the contour centroids, with locations of renal artery and aortic bifurcation marked. Beneath are plots of the cross-sectional area (c) and maximum diameter along the length of the segment (d) ; the portion of the color scale that corresponds to this case is shown registered with scale of cross-sectional area plot. e, Plots of path distance traveled along center axis distally from renal artery (green ) and proximally from aortic bifurcation (blue ). Distances of interest along center axis path can be read from this plot. Journal of Vascular Surgery 2001 33, 700-707DOI: (10.1067/mva.2001.112812) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 6 Anterior view of 3-D reconstruction of AAA repaired with endovascular stent graft. From left to right are shown the aneurysm sac, the stent graft, and a combined view with aneurysm surface represented as a mesh. The diamond markers indicate origins of right and left renal arteries, as labeled. Journal of Vascular Surgery 2001 33, 700-707DOI: (10.1067/mva.2001.112812) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 7 Measurements for repaired AAA shown in Fig 6. a, Mesh representation of aneurysm and with stent graft shown as a solid blue surface.b, Graft is removed from display to show center axis connecting the centroids; location of left renal artery and start of the graft are also shown. c, Cross-sectional area measured at each sample point along vessel center axis. d, Maximum diameter measured at each sample point along vessel center axis. Journal of Vascular Surgery 2001 33, 700-707DOI: (10.1067/mva.2001.112812) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 8 The effect of slice orientation on cross-sectional area measurements is demonstrated for the AAA shown in Fig 4. A, Cross sections corresponding to original image planes. B, Cross sections normal to vessel center axis. The 3-D surface was resampled with 6-mm spacing along center axis. C, Area measurements derived from cross sections in A and B. Cross-sectional area is overestimated when original image planes intersect center axis at oblique angles. Journal of Vascular Surgery 2001 33, 700-707DOI: (10.1067/mva.2001.112812) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions