The cardiac cycle is a major contributor to variability in size measurements of abdominal aortic aneurysms by ultrasound.
OBJECTIVE
The objective of the study was to evaluate the impact of the cardiac cycle on ultrasound measurements of abdominal aortic aneurysm (AAA) diameters.


METHODS
In total, 603 AAAs detected by screening were investigated with respect to the maximal systolic and diastolic anterior-posterior aortic diameters during the cardiac cycle using recorded ultrasound video sequences.


RESULTS
On average, the systolic AAA diameter was 41.60 mm, and the diastolic AAA diameter was 39.63 mm with a paired mean difference at 1.94 mm (p < 0.0001). No association between aneurysmal size and difference in systolic and diastolic size was noted. The mean difference and variability between two observers, one measured during peak-systole and the other measured during end-diastole, was 2.65 and 2.21 mm, respectively, as compared with 0.86 and 1.52 mm, respectively, when both were measured during the peak of systole. The intraobserver variability was 0.94 during systole, 1.18 during diastole and 1.94 mm when systole and diastole measurements were combined.


CONCLUSIONS
The lack of a standardised measurement of the AAA diameter during the cardiac cycle is a potential major contributor to the variability in ultrasonography measurements.
Vascular Research Unit, Viborg Hospital, Postbox 130, 8800 Viborg, Denmark.
N
N
Grøndal
M B
MB
Bramsen
M D
MD
Thomsen
C B
CB
Rasmussen
J S
JS
Lindholt
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001794:Blood Pressure; D003718:Denmark; D003971:Diastole; D006801:Humans; D016014:Linear Models; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000592:standards; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D013599:Systole; D014463:Ultrasonography; D014741:Video Recording