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3.1 Aortic Imaging Techniques to Determine Presence and
Progression of Aortic Disease
COR LOE
Recommendations
1 B-NR 1. In patients with known or suspected aortic disease, aortic
diameters should be measured at reproducible anatomic
landmarks perpendicular to axis of blood flow, and these
measurement methods should be reported in a clear and
consistent manner. In cases of asymmetric or oval contour, the
longest diameter and its perpendicular diameter should be
reported.
1 C-LD 2. In patients with known or suspected aortic disease, episodic
and cumulative ionizing radiation doses should be kept as low
as feasible while maintaining diagnostic image quality.
1 C-EO 3. In patients with known or suspected aortic disease, when
performing CT or MR imaging, it is recommended that
the root and ascending aortic diameters be measured from
inner-edge to inner-edge, using an electrocardiographic-
synchronized technique. If there are aortic wall abnormalities,
such as atherosclerosis or discrete wall thickening (more
common in the distal aorta), the outer-edge to outer-edge
diameter should be reported (Table 4).
1 C-EO 4. In patients with known or suspected aortic disease, the aortic
root diameter should be recorded as maximum sinus to sinus
measurement. In the setting of known asymmetry, multiple
measurements should be reported, and both short- and
long-axis images of the root should be obtained to avoid
underestimation of the diameter.
2a C-LD 5. In patients with known or suspected aortic disease, it is
reasonable that a dilated root or ascending aorta be indexed
to patient height or BSA in the report, to aid in clinical risk
assessment.
2a C-EO 6. In patients with known or suspected aortic disease, when
performing echocardiography, it is reasonable to measure the
aorta from leading-edge to leading-edge, perpendicular to the
axis of blood flow.
Using inner-edge to inner-edge measurements may also be
considered, particularly on short-axis imaging.
2b
3. Imaging and Measurements
Assessment
