Establishing reference values for the pediatric abdominal aorta in MRI

Reference values for the diameter of the thoracic aorta exist for children across all diagnostic imaging procedures, but not for the abdominal aorta. To our knowledge, magnetic resonance imaging (MRI) based reference values for the pediatric abdominal aorta have not yet been published. The aim of this study was to determine reference values for the aortic diameter in a pediatric population using MRI.

150 children (mean age, 9.1 ± 5.6 years) without history or clinical signs of cardiovascular disease underwent MRI, including a three-dimensional stack of stars gradient-recalled-echo sequence with fat-saturation after intravenous contrast administration. Aortic diameters at four levels (diaphragm, celiac trunk, renal arteries, superior to the aortic bifurcation) were measured by two radiologists. Interrater reliability was analyzed using the intraclass correlation coefficient (ICC). Least squares regression models were used to relate aortic diameter to body surface area (BSA). Three model sets were evaluated with the Akaike information criterion to identify the best fit. After determining the optimal model, the influence of sex on diameter measurements was examined. Predicted diameter formulas were derived from the slope estimates, and mean squared error estimates were used to calculate z-scores.

Interrater reliability between the aortic diameter measurements was excellent (ICC, 0.98-0.99). The polynomial regression of the natural logarithm was identified being the best model for all aortic measurements.

Reference diameters for the abdominal aorta in children were determined considering BSA and sex. Data from a healthy population provides a valuable reference for clinical evaluation.

QuestionMRI-based reference values for the pediatric abdominal aorta have not yet been published. FindingsInterrater reliability between the aortic diameter measurements was excellent, and natural logarithmic polynomial regression optimally models the aortic diameter to body surface area. Clinical relevanceEstablishing reference values for the pediatric abdominal aorta is essential for diagnosing and monitoring cardiovascular disease. This study provides normative graphs and tables to assess aortic diameters in relation to body surface area in clinical routine.