Meijboom L J, Groenink M, van der Wall E E, Romkes H, Stoker J, Mulder B J
Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
Int J Card Imaging. 2000 Jun;16(3):161-8. doi: 10.1023/a:1006429603062.
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.
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.
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.
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.
马凡综合征患者可能会发生主动脉根部夹层，尽管标准超声心动图显示主动脉根部仅轻度扩张，这可能是由于主动脉根部不对称所致。本研究的目的是通过磁共振成像（MR）研究马凡综合征患者的主动脉根部不对称性，并将这些测量结果与常规进行的超声心动图检查结果进行比较。
87例马凡综合征患者（平均年龄31±8岁）接受了磁共振成像检查。从该人群中选取了15例患者（平均年龄29±3岁），这些患者在3个月内同时进行了超声心动图和磁共振成像检查。超声心动图检查时，根据美国超声心动图学会的建议测量主动脉根部。磁共振成像检查时，获取主动脉根部的短轴视图，以测量无冠瓣、右冠瓣和左冠瓣之间的距离以及主动脉根部面积。评估主动脉根部面积与直径之间的相关性，并计算95%置信区间（95%CI）。
磁共振成像和超声心动图检查在常规测量的无冠瓣至右冠瓣直径方面未显示差异（42±6mm）。磁共振图像上最大的主动脉根部直径是右冠瓣至左冠瓣直径（46±7mm，p<0.02）。对于给定的无冠瓣至右冠瓣直径，95%置信区间显示主动脉根部面积的变化范围为-20%至+20%。
大多数马凡综合征患者通过磁共振成像显示主动脉根部不对称扩张。当进行标准超声心动图检查时，这种现象可能未被注意到。主动脉根部的不对称性在意外的主动脉根部夹层中可能具有临床重要性。
