Prevelance of aortic root dilation in patients with cta of the aorta

Abstract

272T horacic aortic aneurysm (TAA) is a potentially life-threatening disorder if not diagnosed before the development of dissection and rupture. TAA is defined as a localized dilation of the aorta to more than 50% of baseline. The incidence of TAA is estimated at 6 people per 100,000 per year, and the mean age at diagnosis is 60-70 years. (1). Of all patients presenting with TAA, 60% involve the aortic root and/or ascending aorta (2). The aortic root is described as the part of the aorta that supports the aortic valve leaflets, delineated superiorly by the sinotubular junction (STJ) and inferiorly by the annulus (3). Determination of the segment, or segments involved in the dilation has clinical and surgical significance.Multi-detector row computed tomography (MDCT) is an emerging noninvasive tool for the accurate detection and segmentation of TAA. The current generations of 64-slice scanners, with submillimeter slice collimation and high temporal resolution, have improved our ability to identify and localize TAA. Retrospective electrocardiographically (ECG)-gated MDCT has enabled high quality multiplanar reformation (MPR) and volume-rendered (VR) images. Thus, visualization of the extension of the aneurysm as well as estimation of diameter of the aortic annulus, sinuses of valsalva and sinotubular junction are possible.Although there have been extensive studies on measurements of the aortic valve with MDCT, little imaging information is available on the rate of dilation of the different aortic segments and aortic root structures (4, 5). Recently, Lu et al. (6) reported normal measurements of the ascending aorta (the mean diameters of the coronary sinus, sinotubular junction and ascending aorta were 34.2 mm, 29.7 mm and 32.7 mm, respectively) in 78 patients with MDCT. Accordingly, the present study was undertaken to explore the physical dimensions of the aortic root and its structures at the level of the sinuses of valsalva, annulus, sinotubular junction, and AAo with MPR in a patient population scanned for CTA of the aorta. Materials and methods SubjectsThe patient population participating in this retrospective study was comprised of individuals who had been scanned for thoracic aortic aneurysm and/or dissection at our institution between December 2005 and January 2007. The study was approved by the institutional committee on human research. An honest broker prepared and presented all CT images and medical information in a coded, unidentified manner; the investigators were privy only to the age and sex of individual patients. The data were retrospectively reviewed to exclude all patients documented with coexistent proximal aortic pathology or surgery. Patients with Marfan syndrome, bicuspid aortic valve, or a history of prior MATERIALS AND METHODSIn 95 patients, 64-slice multislice computed tomography was performed for evaluation of the thoracic aorta. Measurements of the annulus, sinuses of valsalva (SOV), sinotubular junction (STJ), and maximum ascending aorta (AAo) were made by double oblique multiplanar re...

Variations of transverse foramens of cervical vertebrae: a 3-dimensional multidetector CT study

“…In previous studies, the size, number, and form variations of TFs were observed and morphometric measurements were done on dry cadaveric materials (2)(3)(4)(5)(6). In the previous studies, it was reported that multidetector computed tomography (MDCT) with 3-dimensional (3D) volume rendering (VR), multiplanar reconstruction (MPR), and maximum intensity projection (MIP) techniques has a very high sensitivity in evaluating anatomic (bony and vascular) variations and anatomic localization (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). To the best of our knowledge, this is the first study in the literature that evaluates the variations of TFs by MDCT.…”

Clinical situations where coronary CT angiography confers superior diagnostic information in comparison to coronary angiography

“…Patients with massive aortic aneurysms encompassing the coronary artery ostia can be evaluated with MDCT-CA (Fig. 11) (46). Performing catheter angiography in these patients is very difficult because the widened lumen makes it almost impossible to locate the ostium with the catheter.…”