BACKGROUND Transthoracic echocardiography (TTE) and magnetic resonance imaging (MRI) have yielded excellent results in aortic root diameter measurement in patients with tricuspid aortic valve. However, accuracy in bicuspid aortic valve (BAV), often associated with aortic root asymmetry, is not fully defined. The aim of this study was to determine the agreement between TTE and MRI in proximal ascending aortic diameters in patients with BAVs. METHODS Seventy-six consecutive patients with BAVs (mean age, 53 ± 15 years; 65% men) who underwent both TTE and MRI for ascending aortic assessment in a follow-up protocol were included in the study. Maximum aortic root and ascending aortic diameters were compared. RESULTS For the whole population, TTE slightly underestimated aortic root diameter (difference, -0.8 ± 2.9 mm; P = .02). However, agreement was significantly better in BAV with fusion of the left and right coronary cusps than with fusion of the right coronary and noncoronary cusps, both with (type 1) and without (type 0) raphe (mean difference, 0.1 ± 2.5 vs -2.8 ± 2.8 mm, P < .001, respectively). In raphe BAV, mean absolute differences of maximum diameters between both techniques were significantly greater in asymmetric versus symmetric aortic roots (3.3 ± 2.2 vs 1.6 ± 1.9 mm, P = .002). BAV type and root asymmetry were independent related to measurement disagreement between both modalities. CONCLUSIONS Although TTE is the technique of choice in the follow-up of patients with BAVs, aortic root diameter measurements may be inaccurate in the presence of root asymmetry and in BAV with fusion of the right coronary and noncoronary cusps. In these cases, cross-sectional imaging, with MRI or computed tomography, to confirm aortic diameters may be advisable.

中文翻译：

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不对称和瓣膜形态对超声心动图测量二尖瓣主动脉主动脉根的影响。

背景经胸超声心动图（TTE）和磁共振成像（MRI）在三尖瓣主动脉瓣患者的主动脉根直径测量中取得了出色的结果。然而，通常与主动脉根不对称相关的二尖瓣主动脉瓣（BAV）的准确性尚未完全定义。这项研究的目的是确定TAV和MRI在BAV患者中近端升主动脉直径之间的一致性。方法本研究纳入了76例连续BAV患者（平均年龄53±15岁；男性65％），这些患者在随访方案中均接受了TTE和MRI升主动脉评估。比较了最大主动脉根和升主动脉直径。结果对于整个人群，TTE略低估了主动脉根直径（差异为-0.8±2.9 mm； P = .02）。然而，左冠状动脉和右冠状动脉融合的BAV协议比右冠状动脉和非冠状动脉融合术都更好，无论是（1型）还是不（0型）缝隙（均值差异，0.1±2.5 vs -2.8± 2.8毫米，分别P <.001）。在裂隙BAV中，两种技术之间最大直径的平均绝对差在不对称主动脉根与对称主动脉根中均显着更大（3.3±2.2 vs 1.6±1.9 mm，P = .002）。BAV类型和根不对称与两种模态之间的测量差异无关。结论尽管TTE是BAV患者随访的首选技术，但是在存在根部不对称的情况下以及在BAV合并右冠状动脉和非冠状动脉尖的情况下，主动脉根直径的测量可能不准确。在这些情况下，