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Reference curves for the aortic area by age
Li-An Wu1, Chung-I Chang, Jou-Kou Wang
1Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan.
Insights
This study established reference curves for aortic cross-sectional area in children and young adults. These formulas aid in diagnosing aortic diseases like coarctation by comparing patient measurements to normal values.
Area of Science:
- Cardiovascular imaging
- Pediatric cardiology
- Radiology
Background:
- Accurate aortic cross-sectional area measurements are crucial for diagnosing pediatric aortic diseases.
- Establishing age- and sex-specific reference values is essential for clinical interpretation.
Purpose of the Study:
- To create reference curves and formulas for aortic cross-sectional area in individuals from infancy to young adulthood.
- To provide tools for the early detection and management of aortic conditions.
Main Methods:
- Retrospective analysis of electrocardiographically gated cardiac computed tomography scans from 65 patients (2 days to 18.1 years).
- Measurement of aortic cross-sectional area at six key locations in normal controls and patients with coarctation of the aorta.
- Assessment of interobserver/intraobserver variability, gender differences, and age-related correlations.
Main Results:
- Aortic cross-sectional area showed a strong correlation with age in normal controls (r > 0.90).
- No significant gender differences were observed in aortic dimensions.
- Distinct area ratios to the descending aorta (DAO) were identified for different aortic segments, differentiating normal controls from patients with coarctation.
Conclusions:
- Aortic area measurement is reproducible and reliable.
- The developed reference curves, formulas, and minimal area ratios offer practical clinical utility.
- These tools facilitate the assessment of aortic dimensions and the identification of abnormalities.
Rationale And Objectives:
The aim of this study was to establish reference curves and formulas for aortic cross-sectional area in patients from infancy to young adulthood.
Materials And Methods:
Patients (aged 2 days to 18.1 years) who underwent electrocardiographically gated cardiac computed tomography between May 2004 and December 2011 were retrospectively examined. These patients were further divided into a group of normal controls (without aortic disease) and a group with coarctation of aorta. In the group of normal controls, the cross-sectional area of the aorta was measured at six locations: the sinotubular junction, distal ascending aorta, proximal arch, distal arch, aortic isthmus, and descending aorta (DAO). Interobserver and intraobserver variability, gender differences, the relationship between aortic cross-sectional areas and age, and the ratio to the DAO were also examined. The area ratio to the DAO was also examined in the group with coarctation of the aorta.
Results:
A total of 65 patients and 365 measurable aortic segments were included in the analysis (55 normal controls and 10 patients with coarctation of aorta). Interobserver and intraobserver variability was limited (aside from measurements of the sinotubular junction). There were no gender differences in age and the cross-sectional areas of the different aortic segments. In the group of normal controls, the cross-sectional area of each aortic segment was highly correlated with age (all >0.90, P < .001). The reference curves and formulas for aortic cross-sectional area by age were also determined for further clinical use. In the normal controls, the <95% confidence intervals of the ratios of aortic isthmus to DAO, distal arch to DAO, and proximal arch to DAO were approximately 0.6, 0.8, and 1.0, respectively. In addition, in the group with coarctation, all area ratios of aortic isthmus to DAO were <0.6, which was significantly different from the group of normal controls (P < .001). The area ratios of distal arch to DAO and proximal arch to DAO were also significantly different between two groups (P < .001 for both).
Conclusions:
Measurement of aortic area was reproducible. The established reference curves and formulas and minimal area ratios were convenient for further clinical use.
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