Aortic root measurement on CT: linear dimensions, aortic root area and comparison with echocardiography. A retrospective cross sectional study

Leong, Kai’En; Knipe, Henry; Binny, S.; Pascoe, Heather; Better, Nathan; Langenberg, Francesca; Lui, Elaine; Joshi, S.

doi:10.1259/bjr.20201232

Cited by 7 publications

(3 citation statements)

References 23 publications

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“…For the aortic root, three measurements were made at mid-sinus level at their maximum dimensions. Cusps were named by the expected coronary artery origin, and commissures go along with them 31 . Aortic root measurements for this study are named as follows (Fig.…”

Section: Table 1 Inclusion and Exclusion Criteria Inclusion Criteriamentioning

confidence: 99%

Normative Computed Tomography Angiography Values of the Aortic Root, Aorta and Aortic arch in Children

Donthula,

Li,

Duvvada

et al. 2024

Preprint

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Purpose Normative values for intracardiac and extracardiac vascular structures help in understanding normal growth and changes over time in children; this normative data are not currently available for ECG-gated Computed Tomography Angiography (CTA). We sought to establish ECG-gated CTA derived normative values for the aortic root, aorta and aortic arch in children. Methods and Results Aortic root, ascending aorta, aortic arch, and descending aorta were measured in systole and diastole in 100 subjects who had ECG-gated CTA at our center between January 2015 through December 2020 and met our inclusion criteria. The allometric exponent (AE) for each parameter was derived, and the parameter/body surface areaAE (BSAAE) was established using the previously described methods. Using this data, normalized mean, cross-sectional area, and standard deviation were calculated. Z-score curves were plotted in relation to the BSA for all measurements. Conclusion Our study reports systolic and diastolic ECG-gated CTA Z-scores along with normative curves in relation to BSA for the aortic root, aorta and aortic arch in children.

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Section: Table 1 Inclusion and Exclusion Criteria Inclusion Criteriamentioning

confidence: 99%

Normative Computed Tomography Angiography Values of the Aortic Root, Aorta and Aortic arch in Children

Donthula,

Li,

Duvvada

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Finally, many other factors may limit the quality of the windows, ultimately limiting the accuracy of aortic measurement. Transesophageal echocardiography (TOE), computed tomography (CT), and magnetic resonance imaging (MRI) may overcome these limitations thanks to their higher spatial resolution and the possibility of performing a comprehensive multiplanar analysis using a three-dimensional (3D) dataset [ 20 ]. For both CT and MRI techniques, ECG-gated acquisition is advisable for improving the accuracy and reproducibility of the aortic measurements because cardiac pulsation and aortic motion may overestimate the maximum diameter.…”

Section: Measuring the Aortic Root And Ascending Aortamentioning

confidence: 99%

Thoracic Aortic Dilation: Implications for Physical Activity and Sport Participation

et al. 2022

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Thoracic aortic dilatation is a progressive condition that results from aging and many pathological conditions (i.e., connective tissue, inflammatory, shear stress disorders, severe valvular heart disease) that induce degenerative changes in the elastic properties, leading to the loss of elasticity and compliance of the aortic wall. Mild aortic root enlargement may be also observed in athletes and is considered as a normal adaptation to regular exercise training. On the other hand, high-intensity physical activity in individuals with a particular genetic substrate, such as those carrying gene variants associated with Marfan syndrome or other inherited aortopathies, can favor an excessive aortic enlargement and trigger an acute aortic dissection. The evaluation of the aortic valve and aortic root diameters, as well as the detection of a disease-causing mutation for inherited aortic disease, should be followed by a tailored decision about sport eligibility. In addition, the risk of aortic complications associated with sport in patients with genetic aortic disease is poorly characterized and is often difficult to stratify for each individual athlete. This review aims to describe the relationship between regular physical activity and aortic dilation, focusing on patients with bicuspid aortic valve and inherited aortic disease, and discuss the implications in terms of aortic disease progression and sport participation.

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“…The ACC/AHA guideline states that the widest diameter, typically at the mid-sinus level, should be used. This CT measurement of the aortic root has shown to have the best reproducibility 14 .…”

Section: Introductionmentioning

confidence: 95%

Discrepancy of echocardiography and computed tomography in initial assessment and 2-year follow-up for monitoring Marfan syndrome and related disorders

Beetz

Trippel

Philipp

et al. 2022

Sci Rep

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Patients with Marfan syndrome and related disorders are at risk for aortic dissection and aortic rupture and therefore require appropriate monitoring. Computed tomography (CT) and transthoracic echocardiography (TTE) are routinely used for initial diagnosis and follow-up. The purpose of this study is to compare whole-heart CT and TTE aortic measurement for initial work-up, 2-year follow-up, and detection of progressive aortic enlargement. This retrospective study included 95 patients diagnosed with Marfan syndrome or a related disorder. All patients underwent initial work-up including aortic diameter measurement using both electrocardiography-triggered whole-heart CT and TTE. Forty-two of these patients did not undergo aortic repair after initial work-up and were monitored by follow-up imaging within 2 years. Differences between the two methods for measuring aortic diameters were compared using Bland–Altman plots. The acceptable clinical limit of agreement (acLOA) for initial work-up, follow-up, and progression within 2 years was predefined as < ± 2 mm. Bland–Altman analysis revealed a small bias of 0.2 mm with wide limits of agreement (LOA) from + 6.3 to − 5.9 mm for the aortic sinus and a relevant bias of − 1.6 mm with wide LOA from + 5.6 to − 8.9 mm for the ascending aorta. Follow-up imaging yielded a small bias of 0.5 mm with a wide LOA from + 6.7 to − 5.8 mm for the aortic sinus and a relevant bias of 1.1 mm with wide LOA from + 8.1 to − 10.2 mm for the ascending aorta. Progressive aortic enlargement at follow-up was detected in 57% of patients using CT and 40% of patients using TTE. Measurement differences outside the acLOA were most frequently observed for the ascending aorta. Whole-heart CT and TTE measurements show good correlation, but the frequency of measurement differences outside the acLOA is high. TTE systematically overestimates aortic diameters. Therefore, whole-heart CT may be preferred for aortic monitoring of patients with Marfan syndrome and related disorders. TTE remains an indispensable imaging tool that provides additional information not available with CT.

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Aortic root measurement on CT: linear dimensions, aortic root area and comparison with echocardiography. A retrospective cross sectional study

Cited by 7 publications

References 23 publications

Normative Computed Tomography Angiography Values of the Aortic Root, Aorta and Aortic arch in Children

Normative Computed Tomography Angiography Values of the Aortic Root, Aorta and Aortic arch in Children

Thoracic Aortic Dilation: Implications for Physical Activity and Sport Participation

Discrepancy of echocardiography and computed tomography in initial assessment and 2-year follow-up for monitoring Marfan syndrome and related disorders

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