Abstract 19638: Short-Axis Echocardiographic Imaging of the Ascending Aorta is More Accurate than Long-Axis Imaging when Compared to Cardiac Magnetic Resonance Imaging and Computed Tomography
Introduction: Parasternal long-axis echo imaging often underestimates aortic dimensions when compared to CT or MRI. More accurate and reproducible echo methods for determining aortic size would benefit care and reduce cost. We compared novel short-axis aortic echo images to standard long-axis and CT or MRI measurements.
Methods: We retrospectively reviewed all cardiac CT/MRI performed in the setting of aortic dilation at Arkansas Children’s Hospital from September 2002 to September 2013. All CT/MRI exams with echocardiograms performed within 3 months were included. One blinded observer reviewed all CT/MRI studies, and measured lateral and anteroposterior dimensions of the aortic sinus (AoS), sinotubular junction (STJ), and ascending aorta (AsAo). Echo measurements were made by 3 independent, blinded observers, and included AoS, STJ, and AsAo in standard long-axis views, as well as novel short-axis measurements: anteroposterior sinus length; maximal left to non-coronary sinus length; and lengths from center right to left coronary sinus or non-coronary sinus. Short-axis anteroposterior and lateral measurements were made of the AsAo at the level of the right pulmonary artery from a high left-parasternal view. All echo measurements were compared to CT/MRI. Pearson product-moment correlation based on Fisher’s transformation was determined for each measure compared to CT/MRI.
Results: Fifty MRIs, 17 CTs, and 62 echocardiograms were identified and reviewed. Adequate imaging for long-axis aortic assessment was present in 48/62 (77%) echocardiograms, and 42/62 (68%) had adequate short-axis images. Fifty-three subjects median age 34.7 years met inclusion criteria. Long-axis measurements correlated well with CT/MRI for AoS (r=0.811), but poorly for AsAo (r=0.094). Short-axis measurements correlated equally well with CT/MRI for AoS (r=0.832), and AsAo (r=0.790).
Conclusions: Parasternal short-axis echo measurements of the aorta are more accurate than conventional parasternal long-axis measurements when compared to CT/MRI. This simple and reproducible technique should be used routinely for echocardiographic evaluation of the aorta.
Author Disclosures: T.W. Kwan: None. R.A. Bornemeier: None. T.H. Best: None. X. Tang: None. J. Gossett: None. R.T. Collins: None.
- © 2014 by American Heart Association, Inc.