Proximal thoracic aortic diameters: transesophageal-echocardiography- versus computed-tomography-derived measurements

Abstract

Purpose To compare proximal aortic measurements from ECG-gated CT to transesophageal echocardiography (TEE) and to evaluate differences in cusp-cusp and cusp-commissure CT measurements of sinus of Valsalva (SOV). Methods This retrospective study (n=25) compared aortic diameters from CT using manual double-oblique multiplanar reformats (MPR) and semiautomatic centerline method to TEE. Results CT MPR and centerline measurements were higher than TEE for sinotubular junction and ascending aorta. At SOV, cusp-cusp diameters (MPR and centerline methods) and cusp-commissure measurement (centerline method) were larger than TEE. Conclusions Aortic measurements were larger on CT than TEE. Precise difference depended on location and measurement technique.

Automatic 3D aortic annulus sizing by computed tomography in the planning of transcatheter aortic valve implantation

“…Importantly, notice that a cMPR was used in our study for the manual analysis, which already tends to present a lower IOV compared to the more traditional double-oblique reconstruction technique (which additionally requires manual alignment and reconstruction of the AoA plane directly in the 3D MDCT image). 22 Such a result emphasizes the increased reproducibility obtained when using the proposed automated framework, in which the user only identifies two points and the software automatically segments and identifies the AoA plane. In the case of a fully automatic analysis, no interaction is required at all, therefore eliminating any userinduced variability.…”

Normal Aortic Root: When One Size Does Not Fit All

“…Although echocardiography remains the most utilized tool, it is unclear if certain at-risk patients should undergo CT imaging with multiplanar reformatting, given that echocardiography will underestimate aortic measurements. 20 With the complexity of the aortic root, the value of 3-dimensional (3D) transesophageal echocardiography (TEE) has been described to improve accuracy; however, recent evidence would suggest that it may not be as accurate as once thought. 21 Given that aortic root and ascending aorta dimensions are critical in transcatheter aortic valve replacement (TAVR), an investigation of 185 TAVR patients compared both 2D and 3D TEE to CT angiography.…”