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Published on: December 9, 2021
Multimodality imaging of aortic dimensions: comparison of transthoracic echocardiography with multidetector row
James F Tsang1, Matthew Lytwyn, Ashraf Farag
1Department of Radiology Institute of Cardiovascular Sciences Section of Cardiology, Department of Internal Medicine, St. Boniface General Hospital, University of Manitoba, Winnipeg, Manitoba, Canada.
Insights
Two-dimensional transthoracic echocardiography (2D TTE) accurately assesses thoracic aortic diameters, offering a feasible alternative to multidetector computed tomography (MDCT). This noninvasive method provides reproducible measurements for evaluating aortic diseases.
Area of Science:
- Cardiovascular Imaging
- Diagnostic Cardiology
- Medical Ultrasound
Background:
- Multimodality cardiac imaging offers various noninvasive methods for aortic disease assessment.
- Multidetector row computed tomography (MDCT) is the gold standard for aortic measurements but has limitations like radiation exposure and contrast-induced nephropathy.
- Two-dimensional transthoracic echocardiography (2D TTE) presents an alternative for assessing aortic root and ascending aorta dimensions.
Purpose of the Study:
- To evaluate the accuracy of 2D TTE in measuring aortic dimensions compared to MDCT.
- To assess the correlation between 2D TTE and MDCT measurements across different aortic segments.
Main Methods:
- Retrospective study involving 116 patients with diverse aortic dimensions.
- Comparison of aortic measurements (annulus, sinuses, sinotubular junction, ascending aorta) obtained via 2D TTE and MDCT.
Main Results:
- Good to excellent correlation was found between 2D TTE and MDCT at all measured aortic levels (r values ranging from 0.84 to 0.93).
- 2D TTE consistently underestimated aortic diameters compared to MDCT.
- Specific diameter measurements by 2D TTE and MDCT were reported for each aortic segment.
Conclusions:
- 2D TTE is a feasible and accurate method for noninvasive assessment of thoracic aortic diameters.
- 2D TTE provides reproducible measurements, serving as a reliable alternative to MDCT for aortic evaluation.
Background:
With recent advances in multimodality cardiac imaging, a number of methods exist for the noninvasive assessment of aortic disease. Although multidetector row computed tomography (MDCT) remains the gold standard for aortic measurements, there are a number of limitations including radiation and contrast-induced nephropathy. Transthoracic echocardiography (TTE) is an alternative to MDCT for providing accurate anatomic assessment of aortic root and ascending aorta dimensions.
Objectives And Methods:
To determine the accuracy of two-dimensional (2D) TTE for determining aortic measurements in comparison to MDCT, a retrospective study of individuals with varying aortic root and ascending aorta dimensions was performed.
Results:
There were 116 patients (77 males, mean age 49 ± 12 years) in total. The maximum aortic diameters by 2D TTE were 26.1 ± 4.3 mm (annulus), 32.4 ± 5.6 mm (sinuses), 30.1 ± 5.9 mm (sinotubular [ST] junction), and 33.4 ± 7.3 mm (ascending aorta). The maximum aortic diameters by MDCT were 30.1 ± 4.1 mm (annulus), 35.8 ± 5.8 mm (sinuses), 33.2 ± 5.9 mm (ST junction), and 37.4 ± 7.6 mm (ascending aorta). There was good to excellent correlation between 2D TTE and MDCT at all four levels of the aorta (annulus: r = 0.84; sinuses: r = 0.93; ST junction: r = 0.93; ascending aorta: r = 0.88). There was a consistent underestimation of aortic measurements obtained by 2D TTE when compared to MDCT.
Conclusion:
2DTTE is a feasible, accurate, and reproducible method for the noninvasive assessment of thoracic aortic diameters as compared to MDCT.
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