CT Scan

[Trackermom]

The CT scan I had of my chest says that on only one image my aorta is 4 cm.  My cardiologist says that because the way the CT cuts the images at an angle one could get a reading larger than what it is.
We will do a MRI in June.  

Has anyone else heard of this?    Wouldn't an aneurysm show up on the other angles of the CT scan and not just one image?

[kenkeith]

Before there is any decision to classify an aorta aneursym there should be some history to determine the aorta's normal size for you.. It is understood that the aorta's size will vary across any given population based on age, gender and body size. Broad ranges of aortic diameters sometimes listed as the normal size of the aorta necessarily span a large variation of body sizes in the population and may be misleading regarding a given individual. It is important that every effort is made to determine the normal aortic diameter for each individual in order to detect the early stages of aortic expansion due to underlying aortic disease.

Generally, in the majority of patients the part of the aorta that is not enlarged may be used as an indicator of what is normal for that individual....for reference the descending aorta is smaller than the ascending aorta because it contains less blood after the branches from the aorta that go to the head come off. The ratio of ascending to descending aorta should normally be about 3:2 but the descending aorta can become relatively larger with age in comparison to the ascending.  Take care.

[Trackermom]

Ken-Thanks you so much for understanding.  Accepting that I will have to be tested once or twice a year is getting easier.  Would rather have a clean bill of health but what can you do, except take the blood pressure medicine.  At least I have the option there are people who never know.

I can't even find things on the internet about having a 4 cm ascending aorta  and living a normal life span, but I'm sure it's possible.  Wish the doctor was a bit more forceful about starting blood pressure medicine earlier then this year.

Thanks again Ken.  

[kenkeith]

I agree it can be frustrating that information provided is not very precise, and sometimes there is a lack of information!  Some of us want to monitor our medical condition and have a copy of reports.  You can look at it not being a problem as the size regardless of location and angle does not meet an aneurysm status, but keep in a watchful mode for any rapid increase in size, and that could indicate a problem that requres treatment. .  

[Trackermom]

I am treating my HBP.  Not, not treating it as I stated in the last paragraph.

[Trackermom]

Hi Ken-
Thank you and I get that what you say but why don't they (radiologist) write down where they measured they aorta?  Seems half -assed if you ask me.  Seems like a no brainer really.

To push to have an echocardiogram and then find out well we don't know where they measured but the part we see is normal.
Well the CT report says that my Ascending Thoracic Aorta is slightly dilated and your telling me my aortic root and the part of the aorta you can see on the ECG is fine.
SO are you seeing the whole ascending aorta or not?  It is 5 cm's.

So I am confused.  I wonder if I should be asking for another CT scan again so that it can be compared if I get the MRI can we believe that one if it says I am fine?
The guy wants to do a MUGA.  I've had four last one in 1999 EF 74% all heart function improved.  All my EF's from the echo's are coming back between 55 and 65%. Why the MUGA?
I should make another appointment with him and discuss this or send a letter.  Why the MUGA? Can you put on the prescription for the MRI to ask at what part of the aorta did you measure?  SHould I skip the MUGA and that radioactive stuff and just get another CT and you ask them for every cm of measurement of the whole aorta?  

Could I trust an MRI?  

I take comfort (I think) in that if the reason is high blood pressure causing this and I am not treating the HBP then I should and could live a long life without it necessarily  going  completely bad and requiring surgery.

I just don't like loose ends and feel like there are loose ends.

[kenkeith]

The size does vary depending on the angle measured and the location.  Generally, an aorta larger than 4.0 cm is considered an anneursym, and at the size does not present much of any risk for dissention.  There may be a problem if the size increases rapidly, and if and when the size is 5.0 cm...then there becomes a danger of rupture.

[Trackermom]

How come the CT Techs and/or the radiologist reading the scan don't say where they are measuring the aorta?

My cardiologist said he doesn't know where they measured it so he couldn't compare my echo because he wasn't sure where they measured.

[Trackermom]

Found something in Contemporary Reviews in Cardiovascular Medicine

one must use caution in measuring the aortic diameter on axial images; such images may slice through the aorta off-axis, resulting in a falsely large diameter