Objective  The aim of this study was to investigate the value of CT texture analysis for volumetric changes of abdominal aortic aneurysm (AAA) after endovascular aneurysm repair (EVAR).

  Methods  Clinical and imaging data of patients with AAA undergoing CT angiography (CTA) at the 3rd and 12th months after EVAR in the Department of Radiology, Peking Union Medical College Hospital between July 2014 and June 2019 were retrospectively collected. Using the traditional measurement as the grouping basis, patients were divided into increased and no-increased groups according to the volume changes during the follow-up. Segmentation software was used to manually outline the maximum axial sections of all aneurysms and extract the texture features of the thrombus. The grey level co-occurrence matrix (GLCM), the grey level run length matrix(GLRLM), and the grey level difference matrix(GLDM) were calculated to analyzed their relationship with the enlargement of the aneurysm volume.

  Results  A total of 70 patients meeting the inclusive and exclusive criteria were enrolled in this study, 29 cases (41.4%, 29/70) in the increased group and 41 (58.6%, 41/70) in the non-increased group. The areas under the ROC curve of GLCM, GLRLM, and GLDM for the diagnosis of increased volumes were 0.892, 0.888, and 0.800, respectively. The best prediction efficiency was shown in GLCM with the sensitivity and specificity of 86.2% and 85.4% respectively. GLDM had the worst pridiction efficiency with a sensitivity of 86.2% and a specificity of 68.3%.

  Conclusion  CT texture analysis might predict the volumetric change of AAA after EVAR.