Aortic root asymmetry in marfan patients; evaluation by magnetic resonance imaging and comparison with standard echocardiography.

L J Meijboom, M Groenink, E E van der Wall, H Romkes, J Stoker, B J Mulder
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引用次数: 74

Abstract

Background: Patients with Marfan syndrome may develop aortic root dissection despite only mild aortic root dilation as shown by standard echocardiography, which may be due to aortic root asymmetry. Purpose of the present study was to investigate aortic root asymmetry by magnetic resonance (MR) imaging in patients with Marfan syndrome and to compare these measurements with standardly performed echocardiography.

Methods: Eighty-seven Marfan patients (mean age 31 +/- 8 years) underwent MR imaging. From this population, 15 patients (mean age 29 +/- 3 years) were selected in whom both echocardiography and MR imaging had been performed within 3 months. With echocardiography, the aortic root was measured according to the recommendations of the American Society of Echocardiography. With MR imaging, a short axis view of the aortic root was obtained to measure distances between the noncoronary, right coronary and left coronary cusps and the aortic root area. Correlations between aortic root area and diameters were assessed, and 95% confidence intervals (95% CIs) calculated.

Results: No difference in the standardly measured noncoronary to right coronary cusp diameter between MR imaging and echocardiography was shown (42 +/- 6 mm). Largest aortic root diameter on the MR images was the right to left coronary cusp diameter (46 +/- 7 mm, p < 0.02). For a given noncoronary to right coronary cusp diameter, 95% confidence intervals revealed a variation of -20 to +20% in the aortic root area.

Conclusions: The majority of Marfan patients show asymmetric dilation of the aortic root by MR imaging. This phenomenon may go unnoticed when standard echocardiography is performed. The asymmetry of the aortic root might be of clinical importance in unexpected aortic root dissection.

马凡氏病患者主动脉根部不对称的研究磁共振成像评价及与标准超声心动图比较。
背景:标准超声心动图显示,马凡综合征患者仅出现轻度主动脉根扩张,但仍可能发生主动脉根夹层,这可能是由于主动脉根不对称所致。本研究的目的是通过磁共振(MR)成像研究马凡氏综合征患者的主动脉根部不对称,并将这些测量结果与标准超声心动图进行比较。方法:87例马凡氏病患者(平均年龄31±8岁)行磁共振成像。从这一人群中选择15例患者(平均年龄29±3岁),他们在3个月内进行了超声心动图和磁共振成像。采用超声心动图,根据美国超声心动图学会的建议测量主动脉根部。通过磁共振成像,获得主动脉根的短轴视图,以测量非冠状动脉、右冠状动脉和左冠状动脉尖头与主动脉根区域之间的距离。评估主动脉根部面积和直径之间的相关性,并计算95%置信区间(95% ci)。结果:磁共振成像与超声心动图在标准测量的非冠状动脉至右冠状动脉尖头直径(42 +/- 6 mm)上无差异。MR图像上主动脉根部最大直径为右至左冠状动脉尖径(46±7 mm, p < 0.02)。对于给定的非冠状动脉到右冠状动脉尖端直径,95%置信区间显示主动脉根部面积的变化为- 20%至+20%。结论:大多数马凡氏病患者mri表现为主动脉根部不对称扩张。当进行标准超声心动图检查时,这种现象可能不会被注意到。主动脉根部的不对称可能对意外的主动脉根部夹层有重要的临床意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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