1. < Aortic Aneurysms

discrepancy between echo and CTA

Posted by marylou78 @marylou78, Jan 26 2:45pm

I was diagnosed with a Bicuspid aortic valve and 4.2 TAA last August via TTE echo. A CTA confirmed aneurism at 4.3 (I'm assuming the .1 difference is well within the margin of error). Anyway, I went to Cleveland Clinic for a 2nd opinion about a week ago (original diagnosis confirmed). However, CC insisted on doing their own TTE echo after my appointment with the Dr. The Dr had told me in advance that TTE echos were primarily for looking at the heart NOT to measure the size of the aorta. However, when I got the results of the echo back it puts the aneurism at 4.6. The CC Dr. doesn't seem concerned, but I'm supposed to follow up with my local cardiologist and have another CTA in March (6 months after first CTA). I'm just looking for some reassurance on this page as I recall there was someone else with a similar story. Part of me is terrified that the aneurysm is actually growing that fast .4 cm in 4 months) and part of me thinks the CC echo is probably just really inaccurate, which I am surprised that my local Dr.'s echo and CTA would almost be identical, yet CC could possibly be this inaccurate in their echo.

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upartist | @upartist | Jan 27 7:03am

I am interested in hearing more about this to. I know its been talked about, but new info will be reassuring. Thanks!!

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degarden_girl | @degarden_girl | Jan 28 11:42am

MaryLou78, I can just imagine your concern about a fast growing aneurysm. So maybe this information will put your mind at rest until you see your cardio next visit. The Echo and the CT measure aortic aneurysms differently. One measures straight across and the other measures on a diagonal -- like the cut of penne pasta -- and the one measured on the diagonal will of course result in a higher number. I can't remember which is which. And then there is the margin of error resulting from different technicians running the testing. From what I understand, aneurysms grow rather slowly (mine has gone from 3.8 to 4.3 in 18 years). I'm sure your cardio has cautioned you against lifting more than a specified weight -- I am limited to 25 lbs. I wish you good luck. I remember how devastated I was to receive my diagnosis so I sympathize with you and I hope your cardio can put your mind at ease.

Donna

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1 reply
marylou78 | @marylou78 | Jan 28 2:52pm
In reply to @degarden_girl "MaryLou78, I can just imagine your concern about a fast growing aneurysm. So maybe this information..." + (show)
@degarden_girl

MaryLou78, I can just imagine your concern about a fast growing aneurysm. So maybe this information will put your mind at rest until you see your cardio next visit. The Echo and the CT measure aortic aneurysms differently. One measures straight across and the other measures on a diagonal -- like the cut of penne pasta -- and the one measured on the diagonal will of course result in a higher number. I can't remember which is which. And then there is the margin of error resulting from different technicians running the testing. From what I understand, aneurysms grow rather slowly (mine has gone from 3.8 to 4.3 in 18 years). I'm sure your cardio has cautioned you against lifting more than a specified weight -- I am limited to 25 lbs. I wish you good luck. I remember how devastated I was to receive my diagnosis so I sympathize with you and I hope your cardio can put your mind at ease.

Donna

Jump to this post

Thank you, my mind is relatively at ease, that it is a reading error. Do you have BAV or any sort of connective tissue disease or genetic abnormality? I have BAV and my understanding is that it will grow significantly faster than someone with TAV (tricuspid aortic valve). I keep hoping to find someone with BAV who has remained the same for a decade to put my mind at ease though

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4 replies
glendamn | @glendamn | Jan 28 6:06pm
In reply to @marylou78 "Thank you, my mind is relatively at ease, that it is a reading error. Do you..." + (show)
@marylou78

Thank you, my mind is relatively at ease, that it is a reading error. Do you have BAV or any sort of connective tissue disease or genetic abnormality? I have BAV and my understanding is that it will grow significantly faster than someone with TAV (tricuspid aortic valve). I keep hoping to find someone with BAV who has remained the same for a decade to put my mind at ease though

Jump to this post

I have BAV and when first diagnosed in Dec 23 , my aneurysm was measured at 4.2 with CT ., second CT in June 24 it was 4.4 and was told that was slow ? . I do not have another screening until this June . And it’s going to be an echo ?? So hard to say what they will measure at? It’s kinda frustrating for sure!!

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degarden_girl | @degarden_girl | Jan 28 6:57pm
In reply to @marylou78 "Thank you, my mind is relatively at ease, that it is a reading error. Do you..." + (show)
@marylou78

Thank you, my mind is relatively at ease, that it is a reading error. Do you have BAV or any sort of connective tissue disease or genetic abnormality? I have BAV and my understanding is that it will grow significantly faster than someone with TAV (tricuspid aortic valve). I keep hoping to find someone with BAV who has remained the same for a decade to put my mind at ease though

Jump to this post

I have the TAV so may not have faced the same experience as you. I hope your next cardio visit will clear up some of the conflicting or concerning info you have.

Wishing you good health.

Donna

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bitsygirl | @bitsygirl | Jan 29 9:10am

Here's a too detailed response from AI that summarizes this study I think (https://pmc.ncbi.nlm.nih.gov/articles/PMC9468173/)

-- TTE tends to systematically overestimate aortic diameters compared to CT.
-- For initial measurements, the limits of agreement are from +5.6 mm to −8.9 mm, meaning that the TTE measurements could be up to 5.6 mm larger or 8.9 mm smaller than the CT measurements. For follow-up measurements, the limits of agreement are from +8.1 mm to −10.2 mm, meaning there’s even more variation between TTE and CT for follow-up measurements.
-- The wide range of these limits indicates that there is substantial variability in the difference between TTE and CT measurements. This means that in some cases, the difference could be quite large, and TTE measurements may not be reliable enough to match CT in terms of precision.

I think there's a lot more to it, but this shows the differences can be quite large, which is consistent with the experience people seem to be having.

If anyone wants to geek out on measurements, there's an overview here: https://www.sciencedirect.com/science/article/pii/S0735109720353237?via%3Dihub

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justwannasay | @justwannasay | Jan 29 10:45am
In reply to @marylou78 "Thank you, my mind is relatively at ease, that it is a reading error. Do you..." + (show)
@marylou78

Thank you, my mind is relatively at ease, that it is a reading error. Do you have BAV or any sort of connective tissue disease or genetic abnormality? I have BAV and my understanding is that it will grow significantly faster than someone with TAV (tricuspid aortic valve). I keep hoping to find someone with BAV who has remained the same for a decade to put my mind at ease though

Jump to this post

Good morning. I have a BAV. Didn't know about it until my GP heard a heart murmur so sent me for an echo in 2018. I am 73yrs. I get one annually. I do not know if I have an aneurysm. No one has said so. But Oct. 2024 the cardio md. tells me I'll need "a valve job, not if, but when" and says likely in 2025. I have access online to my echo results report but do not know how to read it. I have Lupus. So, the seven years of echos has shown a mild/moderate aortic stenosis which I guess has worsened. Anyway.....Take care!!

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marylou78 | @marylou78 | Mar 31 3:36pm

Wanted to update everyone that it was indeed a measuring discrepancy. Just got a CTA that shows that there is no change in aneurysm size in the past 6 months.

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1 reply
didski | @didski | May 7 12:03pm
In reply to @marylou78 "Thank you, my mind is relatively at ease, that it is a reading error. Do you..." + (show)
@marylou78

Thank you, my mind is relatively at ease, that it is a reading error. Do you have BAV or any sort of connective tissue disease or genetic abnormality? I have BAV and my understanding is that it will grow significantly faster than someone with TAV (tricuspid aortic valve). I keep hoping to find someone with BAV who has remained the same for a decade to put my mind at ease though

Jump to this post

I have a BAV and an ascending aorta that measures 4.5. I am 72. The aorta has been stable, measuring 4.5 for 9 years. I have "moderate aortic valve calcification." Yesterday the surgeon I had an appointment with said he expects in 5 years the valve will need replacement at which time the aneurism will be repaired.... even if it tays at 4.5.

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bignelie | @bignelie | May 8 10:04pm
In reply to @marylou78 "Wanted to update everyone that it was indeed a measuring discrepancy. Just got a CTA that..." + (show)
@marylou78

Wanted to update everyone that it was indeed a measuring discrepancy. Just got a CTA that shows that there is no change in aneurysm size in the past 6 months.

Jump to this post

Thank you for the update. I just had the same situation with a Echo and CT being wildly different and this thread helped me put my mind to rest. Trust the CTA number for measurements not the echo.

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