title: Type A aortic dissection: Are there CT signs suggestive of valvular involvement?
abstract: OBJECTIVE
  To identify the predictive signs of aortic valve involvement on the non-electrocardiogram (ECG)-gated admission computed tomography (CT) of patients with Type A aortic dissection (AD) according to the Stanford classification.
  
  
  METHODS
  We retrospectively analyzed the non-ECG-gated CT examinations of patients admitted to the emergency department who underwent surgery for Type A AD over a period of 4 years. The diameter of the following structures was calculated as the mean of the smallest and largest diameters (mm) measured in two different planes: aortic annulus, sinus of Valsalva, sinotubular junction, and proximal ascending aorta. These parameters were compared against operative reports in order to determine whether they were predictive of aortic valve involvement.
  
  
  RESULTS
  In total, 20 patients (13 men and 7 women) of a mean age of 59.5 years (29-80) were included, 55% of patients (11/20) having surgically proven valvular involvement. The mean diameters (inmm) of the aortic annulus, sinus of Valsalva, sinotubular junction and proximal ascending aorta in the group with (and without, respectively) valvular involvement was 27.7 (26.7), 44.3 (38.1), 42.6 (36.6), and 47.8 (45.9). Only the measurement of the mean diameter of the sinuses of Valsalva was significantly predictive (p=0.02) of aortic valve involvement.
  
  
  CONCLUSIONS
  Our findings suggest that measuring the diameter of the sinuses of Valsalva on non-ECG-gated admission CT examinations allows for predicting aortic valve involvement in Type A AD patients.
authors: Department of Radiology, Emergency Radiology Unit, University Hospital of Geneva, 4 rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland. Electronic address: alexandra.platon@hcuge.ch.
authors: Alexandra
authors: A
authors: Platon
authors: Department of Radiology, Emergency Radiology Unit, University Hospital of Geneva, 4 rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland.
authors: Stephane
authors: S
authors: Bernard
authors: Department of Radiology, Emergency Radiology Unit, University Hospital of Geneva, 4 rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland.
authors: Nils
authors: N
authors: Perrin
authors: Division of Cardiovascular Surgery, University Hospital of Geneva, 4 rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland.
authors: Nicolas
authors: N
authors: Murith
authors: Department of Internal medicine/Geriatrics and Rehabilitation, University Hospital of Geneva, 4 rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland; Department of Internal Medicine, Hôpital neuchâtelois, 2300 La Chaux-de-Fonds, Switzerland.
authors: Gregor
authors: G
authors: John
authors: Division of Clinical Epidemiology, University Hospital of Geneva, 4 rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland.
authors: Thomas
authors: T
authors: Perneger
authors: Division of Emergency Medicine, University Hospitals of Geneva and School of Medicine, 4 rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland.
authors: Olivier T
authors: OT
authors: Rutschmann
authors: Department of Radiology, Emergency Radiology Unit, University Hospital of Geneva, 4 rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland.
authors: Pierre-Alexandre
authors: PA
authors: Poletti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000000981:diagnostic imaging*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging*; D001021:Aortic Valve / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012850:Sinus of Valsalva / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Aortic dissection; Aortic valves; Emergency; Non-ECG gated CT