title: Comparative assessment of ascending aortic aneurysms in Marfan patients using ECG-gated computerized tomographic angiography versus trans-thoracic echocardiography.
abstract: BACKGROUND
  Contrast-enhanced computed tomography (CT) is routinely used as a complementary technique to trans-thoracic echocardiography (TTE) for assessing thoracic aortic aneurysms (TAA). However different measures can be obtained on CT and there are no recommendations on which to use. The objective was to determine which CT measurements most closely match reference TTE measurements in Marfan patients with TAA.
  
  
  METHODS
  TTE measurements were obtained using the leading edge-to-leading edge technique in end-diastole on the parasternal longitudinal view. ECG-gated CT measurements were obtained, using the inner-to-inner technique in end-diastole by double oblique reconstruction: on three-cavity view (3C), left ventricle-aorta view (LVAo), and strict transverse plane passing through the maximal diameter "cusp to commissure" and "cusp to cusp" for each cusp. CT and TTE were performed within one month.
  
  
  RESULTS
  44 Marfan patients (39 ± 19 years, 48% men) were included. Dilatation of the ascending aorta was maximal at the level of the sinuses (TTE diameters: mean 47.5 ± 5.3 mm). TTE diameters were similar to 3C, LVAo (mean differences: 2.2 and -0.1 mm, p=NS) and to the three "cusp to cusp" diameters (mean differences ranging from 0 to 1.1mm, p=NS), whereas "cusp to commissure" diameters were all statistically smaller than TTE (3.6 mm, 2.9 mm and 3.7 mm, p ≤ 0.01).
  
  
  CONCLUSIONS
  Inner-to-inner "cusp to cusp" diameter measured on an ECG-gated CT should be used for comparison with 2D TTE aortic diameter at the level of the sinuses of Valsalva in patients with thoracic aortic aneurysms.
authors.affiliation: Department of Cardiology, AP-HP, DHU Fire, Bichat Claude Bernard Hospital, 75018 Paris, France.
authors.forename: Myriam
authors.initials: M
authors.lastname: Amsallem
authors.affiliation: Department of Radiology, AP-HP, DHU Fire, Bichat Claude Bernard Hospital, 75018 Paris, France; Paris René Diderot University, 75018 Paris, France.
authors.forename: Phalla
authors.initials: P
authors.lastname: Ou
authors.affiliation: Department of Cardiology, AP-HP, DHU Fire, Bichat Claude Bernard Hospital, 75018 Paris, France; Centre National de Référence pour le Syndrome de Marfan et apparentés, Bichat Claude Bernard Hospital, 75018 Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Milleron
authors.affiliation: Department of Radiology, AP-HP, DHU Fire, Bichat Claude Bernard Hospital, 75018 Paris, France.
authors.forename: Marie-Cecile
authors.initials: MC
authors.lastname: Henry-Feugeas
authors.affiliation: Department of Cardiology, AP-HP, DHU Fire, Bichat Claude Bernard Hospital, 75018 Paris, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Detaint
authors.affiliation: Centre National de Référence pour le Syndrome de Marfan et apparentés, Bichat Claude Bernard Hospital, 75018 Paris, France; Department of Explorations fonctionnelles, DHU Fire, AP-HP, Bichat Claude Bernard Hospital, 75018 Paris, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Arnoult
authors.affiliation: Department of Cardiology, AP-HP, DHU Fire, Bichat Claude Bernard Hospital, 75018 Paris, France; Paris René Diderot University, 75018 Paris, France.
authors.forename: Alec
authors.initials: A
authors.lastname: Vahanian
authors.affiliation: Department of Cardiology, AP-HP, DHU Fire, Bichat Claude Bernard Hospital, 75018 Paris, France; Paris René Diderot University, 75018 Paris, France; Centre National de Référence pour le Syndrome de Marfan et apparentés, Bichat Claude Bernard Hospital, 75018 Paris, France; LVTS INSERM U1148, Bichat Claude Bernard Hospital, 75018 Paris, France. Electronic address: guillaume.jondeau@bch.aphp.fr.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Jondeau
mesh_terms: D000328:Adult; D001011:Aorta / Q000000981:diagnostic imaging; D001014:Aortic Aneurysm / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D001027:Aortography / Q000592:standards; D017023:Coronary Angiography / Q000592:standards; D004452:Echocardiography / Q000592:standards; D004562:Electrocardiography / Q000592:standards; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008382:Marfan Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000592:standards; D055815:Young Adult
keywords: Computerized tomography; Echocardiography; Marfan syndrome; Sinuses of Valsalva; Thoracic aorta aneurysms