Author + information
- Received January 22, 2020
- Revision received March 20, 2020
- Accepted March 31, 2020
- Published online July 6, 2020.
- John A. Elefteriades, MD, PhD (hon)a,∗ (, )@JElefteriades,
- Sandip K. Mukherjee, MDa,b and
- Hamid Mojibian, MDa,c
- aAortic Institute at Yale-New Haven, Yale University School of Medicine, New Haven, Connecticut
- bSection of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut
- cDepartment of Diagnostic Imaging, Yale University School of Medicine, New Haven, Connecticut
- ↵∗Address for correspondence:
Dr. John A. Elefteriades, Aortic Institute at Yale New Haven, 789 Howard Avenue, Clinic Building, CB-317, New Haven, Connecticut 06519.
• Ascending aortic measurements are often discrepant between or within the modalities of CT, MRI, and echo.
• Discrepancies arise from image formatting, diameter definition, irregular aortic contour, and inconsistent reporting patterns.
• The impact of the following specific factors is explored:
○ Gated or nongated study? Contrast or no contrast study? Wall or no wall? Systole or diastole?
○ Hand measurement or automated centerline measurement?
○ Oblique or orthogonal? Smallest or largest diameter?
○ For the aortic root: sinus-to-commissure or sinus-to-sinus measurement?
Clinicians often encounter discrepant measurements of the ascending aorta that impede, complicate, and impair appropriate clinical assessment—including key issues of presence or absence of aortic growth, rate of growth, and need for surgical intervention. These discrepancies may arise within a single modality (computed tomography scan, magnetic resonance imaging, or echocardiography) or between modalities. The authors explore the origins and significance of these discrepancies, revealing that some “truth” usually underlies all the discrepant measurements, which individually look at the ascending aorta with different perspectives and dimensional definitions. The authors conclude with a practical “question and answer” section that addresses common specific issues in interpretation and management of patients in the real-world setting.
- aortic root
- ascending aorta
- computed tomography
- imaging discrepancies
- thoracic aortic aneurysm
Dr. Elefteriades is Principal of CoolSpine; serves on the Data and Safety Monitoring Board Member for Terumo; and is a consultant for CryoLife. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC author instructions page.
- Received January 22, 2020.
- Revision received March 20, 2020.
- Accepted March 31, 2020.
- 2020 American College of Cardiology Foundation
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