There are many ways to ask if someone has an aneurysm. If the person has prior history of a particular type of aneurysm, say, aortic aneurysm, and the physician suspects that the patient suffers from another one, then specialized imaging instruments that are location-specific can be used. Examples are TRANSESOPHAGEAL ECHOCARDIOGRAPHY or TRANSTHORACIC ECHOCARDIOGRAPHY, they are used to look for abnormalities in the chest and the abdomen. The original data elements provided to us by DUKE and ACC, from which we created the examples in the CV-imaging TAUG, whether a patient has an aneurysm is asked in a pre-specified fashion. The questions would look like the following:
Does the patient have Aortic aneurysm? Aortic arch aneurysm? Suprarenal Abdominal aneurysm? etc.
Row 1:
Shows the presence of coarctation in the aorta. Since "aortic" is included in the CVTEST, the anatomical location is null.
Row 2:
Shows the continued assessment of this same coarctation by capturing its severity. There are three main types of aortic coarctation; preductal, ductal, and postductal. The CVTEST indicates the severity of the preductal coactation. Since "aortic" is included in the CVTEST, the anatomical location is null.
Row 3:
Indicates the presence of an aneurysm in the thoracic aorta.
Row 4:
Shows that the aneurysm led to the dissection of the thoracic aorta.
Row 5:
Shows the confirmed aortic dissection of the thoracic aorta from the previous assessment then undergoes anatomic classification. In this case, the patient's dissection is classified as Standford Class A, indicating that this aortic dissection involves the ascending aorta regardless of the site of origin [ref].
Rows 6-7:
Indicate the absence of aneurysms in both the suprarenal and infrarenal abdominal aorta.
cv.xpt
cv.xpt
Row
STUDYID
DOMAIN
USUBJID
CVSEQ
CVGRPID
CVTESTCD
CVTEST
CVORRES
CVSTRESC
CVLOC
CVMETHOD
VISITNUM
VISIT
CVDTC
1
ABC123
CV
002-2004
1
1
ACRCTIND
Aortic Coarctation Indicator
Y
Y
TRANSTHORACIC ECHOCARDIOGRAPHY
2
BASELINE
2015-06-09T14:20
2
ABC123
CV
002-2004
2
1
APRECSEV
Aortic Preductal Coarctation Severity
INDETERMINATE
INDETERMINATE
TRANSTHORACIC ECHOCARDIOGRAPHY
2
BASELINE
2015-06-09T14:20
3
ABC123
CV
002-2004
3
ANEURIND
Aneurysm Indicator
Y
Y
THORACIC AORTA
TRANSTHORACIC ECHOCARDIOGRAPHY
2
BASELINE
2015-06-09T14:20
4
ABC123
CV
002-2004
4
2
DISECIND
Dissection Indicator
Y
Y
THORACIC AORTA
TRANSTHORACIC ECHOCARDIOGRAPHY
2
BASELINE
2015-06-09T14:20
5
ABC123
CV
002-2004
5
2
STANFADC
Stanford Aortic Dissection Classification
STANFORD CLASS A
STANFORD CLASS A
THORACIC AORTA
TRANSTHORACIC ECHOCARDIOGRAPHY
2
BASELINE
2015-06-09T14:20
6
ABC123
CV
002-2004
6
ANEURIND
Aneurysm Indicator
N
N
SUPRARENAL AORTA
TRANSTHORACIC ECHOCARDIOGRAPHY
2
BASELINE
2015-06-09T14:20
7
ABC123
CV
002-2004
7
ANEURIND
Aneurysm Indicator
N
N
INFRARENAL AORTA
TRANSTHORACIC ECHOCARDIOGRAPHY
2
BASELINE
2015-06-09T14:20
$warningHtml
Dataset Wrapper Debug Message
Please add a row column to your dataset.
However, often times when patients complain about discomforts and pain, it is difficult to pinpoint the exact location of an aneurysm hence MRI and CT scan are the most frequently used tools to detect aneurysm. In this scenario, the test location is often broadly defined as the subject's chest, abdominal cavity or the whole-body. The specific location(s) where aneurysms are found are actually locational qualifiers for the results, not test.
Rows 1-2:
Show subject ABC-123 has a single aortic aneurysm from a chest MRI scan.
Row 3:
Shows the said aneurysm is 7.5cm in length (diameter), which is measured from the aortic arch to the abdominal aorta.
Rows 4-5:
Show subject ABC-456 is found to have aneurysms in two locations from a whole-body MRI Scan: RENAL ARTERY and THORACIC AORTA.
$titleHtml
cv.xpt
Row
STUDYID
DOMAIN
USUBJID
CVSEQ
CVGRPID
CVTEST
CVORRES
CVORRESU
CVLOC
CVMETHOD
VISITNUM
VISIT
CVDTC
CVRESLOC1
CVRESLOC2
CVRLOCTX
1
ABC
CV
ABC-123
1
1
Aneurysm Indicator
Y
CHEST
MRI
1
BASELINE
2020-04-27
2
ABC
CV
ABC-123
2
1
Number of Aneurysms
1
CHEST
MRI
1
BASELINE
2020-04-27
3
ABC
CV
ABC-123
3
1
Aneurysm Length/Diameter
7.5
CM
CHEST
MRI
1
BASELINE
2020-04-27
AORTA
Aortic Arch to Abdominal Aorta
4
ABC
CV
ABC-456
1
2
Aneurysm Indicator
Y
BODY
MRI
1
BASELINE
2020-04-27
5
ABC
CV
ABC-456
2
2
Number of Aneurysms
2
BODY
MRI
1
BASELINE
2020-04-27
RENAL ARTERY
THORACIC AORTA
$warningHtml
Dataset Wrapper Debug Message
Please add a row column to your dataset.
From the CV-imaging project we also encountered use-cases where we need sub-loc variables to help to further specify the detailed, more granular locations where a test is performed. Those values are indeed location information that should NOT be pre-coordinated into the TEST itself, but are also inappropriate for LOC.
This example shows the minor axis cross-sectional diameter measurements of the left and right ventricle of the heart, at end ventricular diastole.
Row 1:
Shows the cross-sectional diameter of the left ventricle at end ventricular diastole, measured along the minor axis and specifically at the location of the high papillary muscle. The further anatomical details at which the measurement is set and performed is represented by the CVLOCTX NSV.
Row 2:
Shows the cross-sectional diameter of the right ventricle at end ventricular diastole, measured along the minor axis and specifically at just below the tricuspid valve. The further anatomical details at which the measurement is set and performed is represented by the CVLOCTX NSV.
