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Normative reference values of major thoracic arterial vasculature in Turkiye
Deniz Esin Tekcan Sanli1,2, Ahmet Necati Sanli3, Onur Yildirim4
1Department of Medical Imaging Techniques, Istanbul Rumeli University, Vocational School of Health Services, Istanbul, Turkiye.
Insights
This study establishes normative values for thoracic arteries in Turkiye, finding that diameters of the aorta and pulmonary artery increase with age and are larger in males than females.
Area of Science:
- Cardiovascular Imaging
- Thoracic Anatomy
- Radiology
Background:
- Establishing normative reference values for thoracic arterial vasculature is crucial for accurate diagnosis and management.
- Previous studies have not comprehensively assessed these values in the Turkish population.
Purpose of the Study:
- To determine normative reference values for major thoracic arteries in Turkiye.
- To investigate the influence of age and gender on these vascular dimensions.
Main Methods:
- Retrospective analysis of low-dose unenhanced chest CT scans from 777 patients.
- Exclusion of patients with pre-existing lung or cardiovascular conditions.
- Standardized measurement of ascending aorta diameter (AAD), descending aorta diameter (DAD), aortic arch diameter (ARCAD), main pulmonary artery diameter (MPAD), right pulmonary artery diameter (RPAD), and left pulmonary artery diameter (LPAD).
- Statistical evaluation using Student's t test and Mann-Whitney U test to assess age and gender differences.
Main Results:
- Mean AAD: 28.52±5.13 mm, ARCAD: 30.83±5.25 mm, DAD: 21.27±3.57 mm, MPAD: 23.27±4.03 mm, RPAD: 17.27±3.19 mm, LPAD: 17.62±3.06 mm.
- All measured thoracic arterial diameters were significantly larger in individuals over 40 years of age.
- Males exhibited significantly larger diameters across all measured thoracic arteries compared to females.
Conclusions:
- Thoracic arterial diameters are consistently larger in males than in females.
- Vascular dimensions of the thoracic aorta and pulmonary artery increase with advancing age.
- These findings provide essential normative data for the Turkish population.
Objective:
The aim of this study was to determine normative reference values for major thoracic arterial vasculature in Turkiye and to evaluate differences according to age and gender.
Methods:
Low-dose unenhanced chest computerized tomography images acquired with pre-diagnosis of COVID-19 between March and June 2020 were evaluated retrospectively. Patients with known chronic lung parenchymal disease, pleural effusion, pneumothorax, chronic diseases such as diabetes, hypertension, obesity, and chronic heart diseases (coronary artery disease, atherosclerosis, congestive heart failure, valve replacement, and arrhythmia) were excluded from the study. The ascending aorta diameter (AAD), descending aorta diameter (DAD), aortic arch diameter (ARCAD), main pulmonary artery diameter (MPAD), right pulmonary artery diameter (RPAD), and the left pulmonary artery diameter (LPAD) were measured in the same sections by standardized methods. The variability of parameters according to age (<40 years; ≥40 years) and gender (male to female) was evaluated by statistical methods. The Student's t test was used to compare the normal distribution according to the given quantitative age and gender, while the data that did not fit the normal distribution were compared with the Mann-Whitney U test. The conformity of the data to the normal distribution was tested with the Kolmogorov-Smirnov, Shapiro-Wilk test, and graphical examinations.
Results:
Totally 777 cases between the ages of 18-96 (43.80±15.98) were included in the study. Among these, 52.8% (n=410) were male and 47.2% (n=367) were female. Mean diameters were 28.52±5.13 mm (12-48 mm in range) for AAD, 30.83±5.25 mm (12-52 mm in range) for ARCAD, DAD 21.27±3.57 mm (11-38 mm in range) for DAD; 23.27±4.03 mm (14-40 mm in range) for MPAD, 17.27±3.19 mm (10-30 mm in range) for RPAD, and 17.62±3.06 mm (10-37 mm in range) for LPAD. Statistically significantly higher values were obtained in all diameters for cases over 40 years of age. Similarly, higher values were obtained in all diameters for males compared to females.
Conclusion:
The diameters of all thoracic main vascular structures are larger in men than in women and increase with age.
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