Published Online
on July 30, 2008

A more recent version of this article appeared on September 1, 2008

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Original Article

Aortic root measurement by cardiovascular magnetic resonance: specification of planes and lines of measurement, and corresponding normal values

Elisabeth D. Burman¹; Jennifer Keegan and Philip J. Kilner

CMR Unit, Royal Brompton Hospital, London, UK

¹ E-mail: e.burman{at}rbht.nhs.uk

Background—Cardiovascular magnetic resonance (CMR) is widely used for aortic root visualization and measurement, but methods still need to be standardized. Our aim was to identify appropriate planes of acquisition and lines of measurement, and record corresponding normal values.

Methods and Results—We studied 120 healthy volunteers, 10 of each gender in each decile between 20 and 80 years, using a 1.5 Tesla CMR system. Steady state free precession cine acquisitions aligned with the left ventricular outflow tract (LVOT) in oblique sagittal and coronal orientations were used to locate two "sinus" planes which transected the root at its widest point in its maximally expanded systolic and at its end diastolic positions. We measured the cusp-cusp and the cusp-commissure dimensions in these cine planes, each as the average of three. Diastolic cusp-commissure dimensions were smaller than diastolic cusp-cusp dimensions (32.0±3.5mm versus 34.6±4.0mm in males, 28.4±2.8mm versus 30.7±3.3mm in females, p<0.001 for both). The diastolic cusp-commissure dimensions increased by 0.9mm per decade in males and 0.7mm per decade in females (p<0.001 for both) and gave higher R² values with respect to age and BSA (0.40 males, 0.27 females) than diastolic cusp-cusp, systolic cusp-commissure, or sinus measurements made in the LVOT planes.

Conclusion—The results indicate the importance of consistent methods for measurement of the aortic root by CMR. We recommend diastolic cusp-commissure measurements, which yielded favorable R² values with respect to age and BSA, and were found to correspond closely with reference echocardiographic root measurements recorded in the Framingham cohort. We record reference values for these and other possible aortic root measurements by CMR.

Key Words: aorta • magnetic resonance imaging • valves • Marfan disease