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Quantitative assessment of the entire thoracic aorta from magnetic resonance images

Published online by Cambridge University Press:  22 December 2010

Ryan K. Johnson ,
Senthil Premraj ,
Sonali S. Patel ,
Andreas Wahle ,
Alan Stolpen ,
Milan Sonka  and
Thomas D. Scholz
Ryan K. Johnson
Affiliation:
Department of Pediatrics, University of Iowa Children’s Hospital, Iowa City, Iowa, United States of America
Senthil Premraj
Affiliation:
Department of Electrical and Computer Engineering, University of Iowa, Iowa City, Iowa, United States of America
Sonali S. Patel
Affiliation:
Department of Pediatrics, University of Iowa Children’s Hospital, Iowa City, Iowa, United States of America
Andreas Wahle
Affiliation:
Department of Electrical and Computer Engineering, University of Iowa, Iowa City, Iowa, United States of America
Alan Stolpen
Affiliation:
Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States of America
Milan Sonka
Affiliation:
Department of Electrical and Computer Engineering, University of Iowa, Iowa City, Iowa, United States of America
Thomas D. Scholz*
Affiliation:
Department of Pediatrics, University of Iowa Children’s Hospital, Iowa City, Iowa, United States of America
*
Correspondence to: T. D. Scholz, MD, Department of Pediatrics, Division of Pediatric Cardiology, University of Iowa Children’s Hospital, 200 Hawkins Drive, 2801 JPP, Iowa City, Iowa 52242, United States of America. Tel: (319) 356 3537; Fax: (319) 356 4693; E-mail: thomas-scholz@uiowa.edu
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Abstract

Objectives

Although magnetic resonance imaging is a primary modality for following patients with connective tissue diseases, only a limited amount of the image data is utilised. The purpose of this study was to show the clinical applicability of an automated four-dimensional analysis method of magnetic resonance images of the aorta and develop normative data for the cross-sectional area of the entire thoracic aorta.

Study design

Magnetic resonance imaging was obtained serially over 3 years from 32 healthy individuals and 24 patients with aortopathy and a personal or family history of connective tissue disorder. Graph theory-based segmentation was used to determine the cross-sectional area for the thoracic aorta. Healthy individual data were used to construct a nomogram representing the maximum cross-sectional area 5th–95th percentile along the entire thoracic aorta. Aortic root diameters calculated from the cross-sectional area were compared to measured diameters from echocardiographic data. The cross-sectional area of the entire thoracic aorta in patients was compared to healthy individuals.

Results

Calculated aortic root diameters correlated with measured diameters from echo data – correlation coefficient was 0.74–0.87. The cross-sectional area in patients was significantly greater in the aortic root, ascending aorta, and descending aorta compared to healthy individuals.

Conclusion

The presentation of the dimensional data for the entire thoracic aorta shows an important clinical tool for following patients with connective tissue disorders and aortopathy.

Keywords

Aortopathyconnective tissue diseaseMarfan syndromethoracic aortic aneurysmcross-sectional area
Type
Original Articles
Information
Cardiology in the Young , Volume 21 , Issue 2 , April 2011 , pp. 170 - 177
Copyright
Copyright © Cambridge University Press 2010

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References

1. François, CJ, Carr, JC. MRI of the thoracic aorta. Cardiol Clin 2007; 25: 171–184.CrossRefGoogle ScholarPubMed
2. Zhao, F, Zhang, H, Wahle, A, et al. Congenital aortic disease: 4D magnetic resonance segmentation and quantatative analysis. Med Image Anal 2009; 13: 483–493.CrossRefGoogle Scholar
3. Colan, SD, McElhinney, DB, Crawford, EC, Keane, JF, Lock, JE. Validation and re-evaluation of a discriminant model predicting anatomic suitability for biventricular repair in neonates with aortic stenosis. J Am Coll Cardiol 2006; 47: 1858–1865.CrossRefGoogle ScholarPubMed
4. Roman, MJ, Devereux, RB, Kramer-Fox, R, O’Loughlin, J. Two-dimensional echocardiographic aortic root dimensions in normal children and adults. Am J Cardiol 1989; 64: 507–512.CrossRefGoogle ScholarPubMed
5. Johnson, RK, Premraj, S, Patel, SS, et al. Automated analysis of four-dimensional magnetic resonance images of the human aorta. Int J Cardiovasc Imaging 2010, 26: 571–578, Epub ahead of print 10 February, 2010.CrossRefGoogle ScholarPubMed
6. Pyeritz, RE, Laschinger, JC, Gillinov, AM, et al. Replacement of the aortic root in patients with Marfan’s syndrome. N Engl J Med 1999; 340: 1307–1313.Google Scholar
7. Roman, ML, Devereux, RB. Aortic disease in Marfan’s syndrome. N Engl J Med 1999; 340: 1358–1359.Google Scholar
8. Gott, VL, Greene, PS, Alejo, DE, et al. Replacement of the aortic root in patients with Marfan’s syndrome. N Engl J Med 1999; 340: 1307–1313.CrossRefGoogle ScholarPubMed
9. Lopez, L, Colan, SD, Frommelt, PC, et al. Recommendations for quantification methods during the performance of a pediatric echocardiogram: a report from the pediatric measurements writing group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council. J Am Soc Echocardiogr 2010; 23: 465–495.CrossRefGoogle ScholarPubMed
10. Meijboom, LJ, Groenink, M, van der Wall, EE, Romkes, H, Stoker, J, Mulder, BJ. Aortic root asymmetry in marfan patients evaluation by magnetic resonance imaging and comparison with standard echocardiography. Int J Card Imaging 2000; 16: 161–168.CrossRefGoogle ScholarPubMed
11. Carrel, T, Beyeler, L, Schnyder, A, et al. Reoperations and late adverse outcome in Marfan patients following cardiovascular surgery. Eur J Cardiothorac Surg 2004; 25: 671–675.CrossRefGoogle ScholarPubMed
12. Engelfriet, PM, Boersma, E, Tijssen, JGP, Bouma, BJ, Mulder, BJM. Beyond the root: dilatation of the distal aorta in Marfan’s syndrome. Heart 2006; 92: 1238–1243.CrossRefGoogle ScholarPubMed
13. Finkbohner, R, Johnston, D, Crawford, ES, Coselli, J, Milewicz, DM. Marfan syndrome. Long-term survival and complications after aortic aneurysm repair. Circulation 1995; 91: 728–733.CrossRefGoogle ScholarPubMed
14. Kawamoto, S, Bluemke, DA, Traill, TA, Zerhouni, EA. Thoracoabdominal aorta in Marfan syndrome: MR imaging findings of progression of vasculopathy after surgical repair. Radiology 1997; 203: 727–732.CrossRefGoogle ScholarPubMed
15. Nollen, GJ, Groenink, M, Tijssen, JGP, Van Der Wall, EE, Mulder, BJM. Aortic stiffness and diameter predict progressive aortic dilatation in patients with Marfan syndrome. Eur Heart J 2004; 25: 1146–1152.CrossRefGoogle ScholarPubMed