Aortic aneurysm: diastol or systol?

The following question has been sent by Sofiane Hadjadj, MD, clinical research, Canada:

For the diagnosis and follow-up of aortic aneurysms the aortic ECG guating ct scan have shown it accuracy beside echo, we still no have concensus about which phase we should measure the aortic diameters, some surgeons here prefere the systol phase other both, what dsct experts have to say about?

thank you

Hatem Alkadhi, MD, University Hospitals Zurich, Switzerland:

Dear Doctor Hadjadj: I completely agree with you in that an accurate assessment of the ascending aorta requires ECG-gating for compensating motion artifacts from the heart. In our institute, we usually measure aortic root dimensions (ie. the aortic annulus, the Sinus of Valsalva, the sinotubular junction and the ascending aorta at the level of the right pulmonary artery) during late systole. This concurs with our cardiologists who perform these measurements with echocardiography also in late systole. I am aware that other centers perform such measurements in mid-systole or even in late diastole and that there is no clear consensus about this topic. Therefore, it is most probably the most important thing to perform the measurments in a similar way as the referring physicians, cardiologists, and cardiovascular surgeons to avoid inconsistencies across the different imaging modalities.