Differing results in echo and CT scan for aortic root aneurysm

[mrsak87]

Hi,

I'm a 29 year old male, fit, slim and at 6 foot. I have cousins with marfins disease but I don't show any characteristics of it. I ended up having an echo which showed aortic root dilation of 4.2cms

However I had a follow up CT scan which showed only 3.2cm. Why the discrepancy and which do I believe? I have another echo in 3 months and have been told I can live normally until then but it's made me anxious about exercise or having drinks with friends

[Ger57]

Yes, 1cm difference is a lot, although I also have seen big differences between different imaging modalities.

I tend to trust the echo results more, but I even have seen very strange results in echo reports that were absent in a follow-up echo.

This does not help your trust in medical diagnosis.
If you have the echo in 3 months, will you trust the outcome if it says 3.2cm? Or if it says 4.2cm?

Still, even if it truly is 4.2cm, it still is far from getting dangerous. Regular measurement to check if the diameter is further increasing is required though.

[mrsak87]

That doesn't help my trust much at all. Gutted about the echo being more reliable because they were so happy for me when they did the CT

So how long do I have before the big operation? 5 years?

[Ger57]

No one can give estimates on that, time will tell. I know a person with a 3.8cm stable root diameter for many years now.

If the echo would be less trustworthy that the CT, then why choose the echo for a check in 3 months?

[mrsak87]

That's just what I've been advised by my cardiologist. Why do a CT if they know my echo already? I know in my heart when I get my second echo it's just going to confirm that I have an aneurysm. The CT just gave me false hope

[Ger57]

In a situation of an aneurysm, the worst thing that can happen is underestimation of the size and getting a rupture before surgery.
In case the doubt remains about the size, I would take the appropriate measures that belong to the larger estimation.

But don't be too pessimistic.
It can very well be that:
-the previous echo was overestimated with 4.2 and the size measured in 3 months is somewhat lower
-4.2cm is confirmed but does not increase further
-in time you need aneurysm repair, but it can be fixed with a catheter procedure (endovascular stent)