Screening Method Discrepancies

Yes - measurements are off. My first CT which found the aneurysm was 4.8, then another with contrast 4.5. Then an echo 4.5, then a CT w/o contrast (I had afib) 4.4. Then another CT w/contrast 4.6. The surgeon said let’s call it 4.6. I was just happy it wasn’t 4.8! Welcome to the club that nobody wants to be a part of. You’ll learn a lot here. Your anxiety will drop. Good luck.

Hello.....a Radiologist interpreted a recent CT of mine and said my TAA was at 4.9cm. My cardiologist remeasured and he showed 4.5cm. Size is relative to who's measuring. Needless to say, I'm getting a gated CT-A in a couple months for comparison.

Hello,

On March 4th, an MRI scan of the blood vessels was performed (private clinic). The results showed that I had a dilation of the ascending aorta, measured at 47 mm.

On March 15th, I had an ultrasound (at another private clinic). The cardiologist saw a dilation of 40 mm, but given my height, age, and weight (190 cm / 115 kg and 53 y), this was not particularly unusual. Naturally, I was very surprised and also quite confused.

I contacted the hospital that performed the MRI and asked where this discrepancy came from, and the answer I received was the following: The MRI clearly shows that the dilation is larger than 40 mm, but the measurements can also deviate slightly.

This coming Saturday, I have another ultrasound at someone else's (private clinic), and on March 31st, I am going to the hospital for a very extensive examination based on the results of the first MRI scan. I will come back to the differences in the measurement results.

@wanneram
4.0 cm and 4.7 cm is a significant discrepancy. By ultrasound, do you mean echocardiogram?

I was diagnosed in January of 2024 with a 4.0 aortic root aneurysm. It was found on a routine Echo cardio gram. I then had a CT to confirm it. But it was measured at 4.5 on my CT. So I then had an MRI that also measured at 4.5. But it is slowly growing . My last reading was at 4.6 in August. I hope this helps you.

@rlhix

yes ,a echocardiogram.

An echo which is based on ultrasound is not precise. It is okay for screening but it is not the number you can believe.
A CT angiogram is believed to give precise numbers. That is what academic centers that specialize in ascending aortic aneurysms use.
If you have not done so already, you might want to see a CV surgeon or even a cardiologist at a center that does a high volume of ascending aortic aneurysm repairs.

(This coming Saturday, I have another ultrasound at someone else's (private clinic), and on March 31st, I am going to the hospital for a very extensive examination based on the results of the first MRI scan. I will come back to the differences in the measurement results)

On Saturday, March 28, I went to another (private) clinic for my second ultrasound. I requested that extra attention be paid to the diameter of the ascending aorta and the root.

The results were double-checked; the findings are root 41 mm and ascending aorta 39 mm. The valves are functioning well, and blood pressure is good.

On March 31, I finally went to the hospital for an intake at the cardiology department. I indicated there that there was a large discrepancy between the MRI and the two ultrasounds. According to the cardiologist, the difference is too large. So, something went wrong somewhere.

I also had a very comprehensive ultrasound here, and an ultrasound from the same hospital from 2015 was also available for comparison. The echocardiogram was performed by two radiologists who checked each other's readings. The measurement was subsequently verified by the radiologists and the cardiologist re-measured everything thoroughly for extra certainty, and this also came to 40 mm for the ascending aorta.

During the results discussion, the cardiologist indicated that, given my BSA and age, there is nothing unusual going on. However, I did suggest that, for the sake of my anxiety and uncertainty, it would be better to have a CT scan performed for 100% certainty.

The cardiologist complied with this, and I will have the CT scan at the hospital on May 18th.

The cardiologist did indicate that he did not doubt the three echocardiograms, which showed 40 mm, 39 mm, and 40 mm respectively—taken in three different clinics and by different radiologists and cardiologists, and all double-checked for diameter.

What I do find strange is that various publications mention different ultrasound results if the scan is performed by different radiologists and at different times. These results correspond quite closely.

I am now waiting for the scan on May 18 and will share the result here.

@wanneram I had a period of time where there was a slight difference between CT scan and thoracic echocardiogram, but the difference was minimal.. I have a sinus of the valsalva aneurysm and bicuspid aortic valve. Last thoracic echocardiogram showed 4.5 mm.

@tomcgauley

Thanks for your reply.

I don't dare get my hopes up until the CT scan, that initial diagnosis of 47 mm has had a major impact on me.

I am hardened by all kinds of severe setbacks in my life, but not when it comes to my health.

How much longer do you have to wait before you qualify for surgery? I assume that because of that bicuspid aortic valve, they aren't going to wait until 55 mm?