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Which morphological abnormalities better define the elongation of transverse aortic arch: a magnetic resonance angiography study
- Department of Radiology, University of Health Sciences, Faculty of Medicine, Ankara Health Practice and Research Centre, Ankara, Türkiye
open access
Abstract
Background: The aim of the study is to investigate the relation between morphological abnormalities that might indicate elongation of transverse aortic arch (ETA) and various aortic and thoracic measurements, and to determine which morphological criteria define the elongated transverse arch better.
Materials and methods: Patients under 40 years of age who underwent contrast enhanced thoracic magnetic resonance angiography were included in the study. Images were evaluated for the presence of morphological arch abnormalities such as late take off (LTO) of left subclavian artery (LSA), flattening of the arch, and kinking at the posterior or anterior contour of the lesser curvature. Various aortic and thoracic measurements, including the distance between the orifices of the left common carotid artery (LCCA) and LSA, were made. Statistical relation between morphological abnormalities and these measurements was analysed. The effect of morphological abnormalities and their combinations on the distance between LCCA and LSA orifices was evaluated by linear regression analysis.
Results: Ninety three cases were included in the study. All morphological abnormalities and most of their combinations show statistically significant relation with longer LCCA to LSA distance. The parameters that most affected this distance were combination of flattening with LTO of LSA, anterior kinking and combination of anterior kinking with both flattening and LTO, respectively.
Conclusions: Our study showed that the finding which best defines ETA is the combination of LTO and arch flattening. Therefore, we recommend using this combination in the diagnosis of ETA instead of the classical diagnostic criteria including combination of LTO and posterior kinking.
Abstract
Background: The aim of the study is to investigate the relation between morphological abnormalities that might indicate elongation of transverse aortic arch (ETA) and various aortic and thoracic measurements, and to determine which morphological criteria define the elongated transverse arch better.
Materials and methods: Patients under 40 years of age who underwent contrast enhanced thoracic magnetic resonance angiography were included in the study. Images were evaluated for the presence of morphological arch abnormalities such as late take off (LTO) of left subclavian artery (LSA), flattening of the arch, and kinking at the posterior or anterior contour of the lesser curvature. Various aortic and thoracic measurements, including the distance between the orifices of the left common carotid artery (LCCA) and LSA, were made. Statistical relation between morphological abnormalities and these measurements was analysed. The effect of morphological abnormalities and their combinations on the distance between LCCA and LSA orifices was evaluated by linear regression analysis.
Results: Ninety three cases were included in the study. All morphological abnormalities and most of their combinations show statistically significant relation with longer LCCA to LSA distance. The parameters that most affected this distance were combination of flattening with LTO of LSA, anterior kinking and combination of anterior kinking with both flattening and LTO, respectively.
Conclusions: Our study showed that the finding which best defines ETA is the combination of LTO and arch flattening. Therefore, we recommend using this combination in the diagnosis of ETA instead of the classical diagnostic criteria including combination of LTO and posterior kinking.
Keywords
elongation of transverse aortic arch, cardiovascular abnormalities, anatomy, magnetic resonance angiography
Title
Which morphological abnormalities better define the elongation of transverse aortic arch: a magnetic resonance angiography study
Journal
Issue
Article type
Original article
Pages
583-589
Published online
2020-08-22
Page views
6925
Article views/downloads
776
DOI
Pubmed
Bibliographic record
Folia Morphol 2021;80(3):583-589.
Keywords
elongation of transverse aortic arch
cardiovascular abnormalities
anatomy
magnetic resonance angiography
Authors
H. Yiğit
E. Ergün
P. N. Koşar
- Bondy CA. Turner Syndrome Study Group. Care of girls and women with Turner syndrome: a guideline of the Turner Syndrome Study Group. J Clin Endocrinol Metab. 2007; 92(1): 10–25.
- Chen J, Gutmark E, Mylavarapu G, et al. Numerical investigation of mass transport through patient-specific deformed aortae. J Biomech. 2014; 47(2): 544–552.
- Ece B, Yiğit H, Ergün E, et al. Elongated transverse aortic arch in subjects without turner syndrome: A preliminary computed tomography study. Clin Anat. 2018; 31(6): 887–890.
- Granger A, Zurada A, Zurada-Zielińska A, et al. Anatomy of turner syndrome. Clin Anat. 2016; 29(5): 638–642.
- Gutmark-Little I, Backeljauw PF, Gutmark-Little I, et al. Partial anomalous pulmonary venous return is common in Turner syndrome. J Pediatr Endocrinol Metab. 2012; 25(5-6): 435–440.
- Ho VB, Bakalov VK, Cooley M, et al. Major vascular anomalies in Turner syndrome: prevalence and magnetic resonance angiographic features. Circulation. 2004; 110(12): 1694–1700.
- Kim HK, Gottliebson W, Hor K, et al. Cardiovascular anomalies in Turner syndrome: spectrum, prevalence, and cardiac MRI findings in a pediatric and young adult population. Am J Roentgenol. 2011; 196(2): 454–460.
- Mortensen KH, Hjerrild BE, Andersen NH, et al. Abnormalities of the major intrathoracic arteries in Turner syndrome as revealed by magnetic resonance imaging. Cardiol Young. 2010; 20(2): 191–200.
- Mosteller RD. Simplified calculation of body-surface area. N Engl J Med. 1987; 317(17): 1098.
- Prahl Wittberg L, van Wyk S, Fuchs L, et al. Effects of aortic irregularities on blood flow. Biomech Model Mechanobiol. 2016; 15(2): 345–360.
- Yiğit H, Ergün E. Elongation of transverse aortic arch; not specific for Turner Syndrome. Clin Anat. 2017; 30(5): 555–556.
- Yiğit H, Önder A, Özgür S, et al. Cardiac MRI and 3D contrast-enhanced MR angiography in pediatric and young adult patients with Turner syndrome. Turk J Med Sci. 2017; 47(1): 127–133.