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Comparative assessment of ascending aortic aneurysms in Marfan patients using ECG-gated computerized tomographic

Myriam Amsallem1, Phalla Ou2, Olivier Milleron3

  • 1Department of Cardiology, AP-HP, DHU Fire, Bichat Claude Bernard Hospital, 75018 Paris, France.

International Journal of Cardiology
|February 24, 2015
PubMed

Insights

For Marfan patients with thoracic aortic aneurysms (TAA), "cusp to cusp" CT measurements closely match TTE reference diameters. This provides a standardized approach for comparing imaging modalities in TAA assessment.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Contrast-enhanced computed tomography (CT) and trans-thoracic echocardiography (TTE) are used for assessing thoracic aortic aneurysms (TAA).
  • Standardized CT measurement protocols are lacking for TAA assessment.
  • Marfan syndrome patients with TAA require accurate diameter measurements for management.

Purpose of the Study:

  • To identify which CT measurements best correlate with TTE reference measurements in Marfan patients with TAA.
  • To establish a standardized method for comparing CT and TTE in TAA evaluation.
  • To guide clinical practice in TAA diameter assessment.

Main Methods:

  • Measurements were taken using the leading edge-to-leading edge technique (TTE) and inner-to-inner technique (CT) in end-diastole.
  • ECG-gated CT measurements utilized double oblique reconstructions including three-cavity (3C), left ventricle-aorta (LVAo), and transverse planes.
  • CT and TTE were performed within one month for direct comparison.

Main Results:

  • Forty-four Marfan patients with TAA were analyzed.
  • TTE diameters at the sinuses of Valsalva averaged 47.5 ± 5.3 mm.
  • Inner-to-inner "cusp to cusp" CT diameters showed minimal and non-significant differences compared to TTE (0-1.1 mm).

Conclusions:

  • Inner-to-inner "cusp to cusp" diameter measurements on ECG-gated CT are recommended for comparison with 2D TTE aortic diameters.
  • This method provides reliable assessment of the sinuses of Valsalva in Marfan patients with TAA.
  • Standardized CT measurements improve comparability with echocardiography for TAA management.
Abstract

Keywords:
Computerized tomographyEchocardiographyMarfan syndromeSinuses of ValsalvaThoracic aorta aneurysms

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