This study aimed to assess the error of different registration techniques and imaging modalities for fusion imaging of the aorta in a standardized setting using a anthropomorphic body phantom. A phantom with the 3D printed vasculature of a patient suffering from an infrarenal aortic aneurysm was constructed. Pulsatile flow was generated via an external pump. CTA/MRA of the phantom was performed, and a virtual 3D vascular model was computed. Subsequently, fusion imaging was performed employing 3D-3D and 2D-3D registration techniques. Accuracy of the registration was evaluated from 7 right/left anterior oblique c-arm angulations using the agreement of centerlines and landmarks between the phantom vessels and the virtual 3D virtual vascular model. Differences between imaging modalities were assessed in a head-to-head comparison based on centerline deviation. Statistics included the comparison of means ± standard deviations, student’s t-test, Bland-Altman analysis, and intraclass correlation coefficient for intra- and inter-reader analysis. 3D-3D registration was superior to 2D-3D registration, with the highest mean centerline deviation being 1.67 ± 0.24 mm compared to 4.47 ± 0.92 mm. The highest absolute deviation was 3.25 mm for 3D-3D and 6.25 mm for 2D-3D registration. Differences for all angulations between registration techniques reached statistical significance. A decrease in registration accuracy was observed for c-arm angulations beyond 30° right anterior oblique/left anterior oblique. All landmarks (100%) were correctly positioned using 3D-3D registration compared to 81% using 2D-3D registration. Differences in accuracy between CT and MRI were acceptably small. Intra- and inter-reader reliability was excellent. In the realm of registration techniques, the 3D-3D method proved more accurate than did the 2D-3D method. Based on our data, the use of 2D-3D registration for interventions with high registration quality requirements (e.g., fenestrated aortic repair procedures) cannot be fully recommended. Regarding imaging modalities, CTA and MRA can be used equivalently.

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主动脉血管内介入融合成像中配准技术和血管成像方式的准确性：一项幻像研究

本研究旨在评估不同配准技术和成像方式在标准化设置中使用拟人身体模型对主动脉进行融合成像的误差。构建了一个具有 3D 打印血管系统的体模，该患者患有肾下主动脉瘤。脉动流是通过外部泵产生的。对体模进行 CTA/MRA，并计算虚拟 3D 血管模型。随后，融合成像采用 3D-3D 和 2D-​​3D 配准技术进行。使用虚拟血管和虚拟 3D 虚拟血管模型之间的中心线和标志的一致性，从 7 个右/左前斜 c 臂角度评估配准的准确性。在基于中心线偏差的头对头比较中评估成像方式之间的差异。统计数据包括平均值 ± 标准差的比较、学生的 t 检验、Bland-Altman 分析和用于读者内和读者间分析的类内相关系数。3D-3D 配准优于 2D-3D 配准，最高平均中心线偏差为 1.67 ± 0.24 mm，而 4.47 ± 0.92 mm。3D-3D 的最高绝对偏差为 3.25 毫米，2D-3D 配准的绝对偏差为 6.25 毫米。配准技术之间所有角度的差异达到统计显着性。对于超过 30° 右前斜肌/左前斜肌的 c 臂角度，观察到配准精度下降。使用 3D-3D 配准正确定位所有地标 (100%)，而使用 2D-3D 配准则为 81%。CT 和 MRI 之间的准确性差异很小，可以接受。阅读器内和阅读器间的可靠性非常好。在配准技术领域，3D-3D 方法证明比 2D-3D 方法更准确。根据我们的数据，不能完全推荐将 2D-3D 配准用于具有高配准质量要求的干预措施（例如开窗主动脉修复手术）。关于成像方式，CTA和MRA可以等效使用。不能完全推荐将 2D-3D 配准用于具有高配准质量要求的干预措施（例如开窗主动脉修复手术）。关于成像方式，CTA和MRA可以等效使用。不能完全推荐将 2D-3D 配准用于具有高配准质量要求的干预措施（例如开窗主动脉修复手术）。关于成像方式，CTA和MRA可以等效使用。