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Journal of Cardiovascular Magnetic Resonance

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Open Access 01-12-2017 | Research

Continuous measurement of aortic dimensions in Turner syndrome: a cardiovascular magnetic resonance study

Authors: Dhananjay Radhakrishnan Subramaniam, William A. Stoddard, Kristian H. Mortensen, Steffen Ringgaard, Christian Trolle, Claus H. Gravholt, Ephraim J. Gutmark, Goutham Mylavarapu, Philippe F. Backeljauw, Iris Gutmark-Little

Published in: Journal of Cardiovascular Magnetic Resonance | Issue 1/2017

Abstract

Background

Severity of thoracic aortic disease in Turner syndrome (TS) patients is currently described through measures of aorta size and geometry at discrete locations. The objective of this study is to develop an improved measurement tool that quantifies changes in size and geometry over time, continuously along the length of the thoracic aorta.

Methods

Cardiovascular magnetic resonance (CMR) scans for 15 TS patients [41 ± 9 years (mean age ± standard deviation (SD))] were acquired over a 10-year period and compared with ten healthy gender and age-matched controls. Three-dimensional aortic geometries were reconstructed, smoothed and clipped, which was followed by identification of centerlines and planes normal to the centerlines. Geometric variables, including maximum diameter and cross-sectional area, were evaluated continuously along the thoracic aorta. Distance maps were computed for TS and compared to the corresponding maps for controls, to highlight any asymmetry and dimensional differences between diseased and normal aortae. Furthermore, a registration scheme was proposed to estimate localized changes in aorta geometry between visits. The estimated maximum diameter from the continuous method was then compared with corresponding manual measurements at 7 discrete locations for each visit and for changes between visits.

Results

Manual measures at the seven positions and the corresponding continuous measurements of maximum diameter for all visits considered, correlated highly (R-value = 0.77, P < 0.01). There was good agreement between manual and continuous measurement methods for visit-to-visit changes in maximum diameter. The continuous method was less sensitive to inter-user variability [0.2 ± 2.3 mm (mean difference in diameters ± SD)] and choice of smoothing software [0.3 ± 1.3 mm]. Aortic diameters were larger in TS than controls in the ascending [TS: 13.4 ± 2.1 mm (mean distance ± SD), Controls: 12.6 ± 1 mm] and descending [TS: 10.2 ± 1.3 mm (mean distance ± SD), Controls: 9.5 ± 0.9 mm] thoracic aorta as observed from the distance maps.

Conclusions

An automated methodology is presented that enables rapid and precise three-dimensional measurement of thoracic aortic geometry, which can serve as an improved tool to define disease severity and monitor disease progression.

Trial registration

ClinicalTrials.gov Identifier - NCT01678274. Registered - 08.30.2012.

Available only for authorised users

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Title: Continuous measurement of aortic dimensions in Turner syndrome: a cardiovascular magnetic resonance study
Authors: Dhananjay Radhakrishnan Subramaniam
William A. Stoddard
Kristian H. Mortensen
Steffen Ringgaard
Christian Trolle
Claus H. Gravholt
Ephraim J. Gutmark
Goutham Mylavarapu
Philippe F. Backeljauw
Iris Gutmark-Little
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: Journal of Cardiovascular Magnetic Resonance / Issue 1/2017
Electronic ISSN: 1532-429X
DOI: https://doi.org/10.1186/s12968-017-0336-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Continuous measurement of aortic dimensions in Turner syndrome: a cardiovascular magnetic resonance study

Abstract

Background

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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