Dimensional Analysis of Aortic Root Geometry During Diastole Using 3D Models Reconstructed from Clinical 64-Slice Computed Tomography Images

Accurate measurement of anatomical characteristics of the aortic root is needed for pre-procedural planning of many valve procedures and development of novel valve intervention devices. Dimensional measurement of the aortic root is currently performed on 2-dimensional (2D) images, rather than on a full 3-dimensional (3D) geometric model. In this study, full 3D aortic root geometric models, reconstructed from clinical multi-slice computed tomography (MSCT) scans during diastole, were used to perform dimensional analysis of the aortic root geometry of 94 patients. Thirty-two landmark points were placed on anatomic feature locations of each aortic root model for the measurement of aortic root dimensions. Diameters of the annulus, sinus of Valsalva (SOV), sino-tubular junction, and ascending aorta were compared with measurements obtained from 2D MSCT images in short axes. Additionally, the spatial distribution of the left coronary ostium (CO) within the left coronary sinus (LCS) was determined due to its significance in transcatheter aortic valve implantation. Aortic root dimensions measured by 3D models had good correlations with those measured by 2D MSCT images. The 3D perimeter-derived annulus and SOV diameters were larger than the direct measured diameters on short axis views. Additionally, this study indicated that the left CO is predominantly located in the upper right region of the LCS. Similar results could be obtained using the 3D models compared to 2D MSCT images. Since anatomical features of the aortic root can be easily identified on a full 3D geometric model, more complete information could be obtained.

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