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Normative computed tomography angiography values of the aortic root, aorta, and aortic arch in children
Rakesh Donthula1, Wen Li2,3, Archita Duvvada4
1The University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston, TX, 77030, USA.
Insights
This study establishes normative values for pediatric aortic structures using ECG-gated CTA, providing crucial Z-scores and growth curves for accurate assessment of the aortic root, aorta, and aortic arch.
Area of Science:
- Pediatric cardiovascular imaging
- Thoracic computed tomography angiography
- Vascular development
Background:
- Normative data for pediatric vascular structures exists for echocardiography, cardiac MRI, and non-ECG gated CTA.
- Standard deviation-based Z-scores are common but exhibit heteroscedasticity across pediatric body sizes.
Purpose of the Study:
- To establish normative values for the aortic root, aorta, and aortic arch in children using ECG-gated computed tomography angiography (CTA).
- To derive systolic and diastolic Z-scores and normative curves relative to body surface area (BSA).
Main Methods:
- Measured aortic root, ascending aorta, aortic arch, and descending aorta in systole and diastole in 100 pediatric subjects.
- Utilized ECG-gated CTA data from January 2015 to December 2020.
- Derived allometric exponents and normalized parameters by BSAAE, calculating mean, cross-sectional area, and standard deviation to plot Z-score curves.
Main Results:
- Established systolic and diastolic Z-scores for the aortic root, aorta, and aortic arch in children.
- Generated normative curves plotted against BSA for all measured aortic parameters.
- This is the first study to provide ECG-gated CTA-derived normative data for these pediatric aortic structures.
Conclusions:
- Reports the first set of systolic and diastolic ECG-gated CTA Z-scores for pediatric aortic structures.
- Provides normative curves relative to BSA for the aortic root, aorta, and aortic arch in children.
- Facilitates improved assessment of normal growth and identification of abnormalities in pediatric aortic anatomy.
Abstract:
Normative values for intracardiac and extracardiac vascular structures help in understanding normal growth and changes over time in children; this normative data is 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. 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 and 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.
What Is Known:
• Normative data for intracardiac and extracardiac vascular structures in the pediatric population are available for echocardiography, cardiac MRI and non-ECG gated CTA. • Z-scores with standard deviations are commonly used in children, but SDs are not constant across body sizes due to heteroscedasticity.
What Is New:
• Allometric exponent was derived for each parameter and the parameter/body surface area (BSA) was established. • This is the first ECG-gated CTA study to provide normative en face systolic, diastolic diameters and cross-sectional areas along with Z-scores and normative curves for the aortic root, aorta and aortic arch in children.
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