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DOI: 10.1055/s-2008-1027652
© Georg Thieme Verlag KG Stuttgart · New York
Unicuspid Aortic Valve Disease: a Magnetic Resonance Imaging Study
Die unikuspide Aortenklappe: eine MRT-StudiePublikationsverlauf
received: 14.3.2008
accepted: 19.6.2008
Publikationsdatum:
23. September 2008 (online)
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Zusammenfassung
Ziel: Kongenitale Klappenanomalien sind häufig bei Erwachsenen mit Aortenklappenfehlern. Neben der bikuspiden Aortenklappe findet man darunter selten unikuspide Aortenklappen (UAV). Ziel der Studie war es, die Klappenmorphologie und die Dimensionen der thorakalen Aorta bei 12 Patienten mit UAV im Vergleich zur trikuspiden Aortenklappenerkrankung (TAV) mittels MRT zu beschreiben. Material und Methoden/Ergebnisse: Insgesamt wurden 288 Patienten mit Aortenkappenfehlern im MRT untersucht (1,5 T, Sonata, Siemens Medical Solutions). Davon wurden retrospektiv 12 Aortenklappen als unikuspide klassifiziert. Die Fläche des Aortenklappenanulus und die Dimensionen der thorakalen Aorta wurden retrospektiv mit einer Kohorte von 103 Patienten mit TAV verglichen. Bei allen Patienten mit UAV war die Klappenmorpholgie unikuspide unikommissural mit einer posterioren Kommissur. Die mittlere Anulusfläche und die Diameter der Aorta ascendens der Patienten mit UAV waren signifikant größer im Vergleich zu den Patienten mit TAV (12,6 ± 4,7 cm2 vs. 8,7 ± 2,3 cm2, p < 0,01 und 4,6 ± 0,7 cm vs. 3,6 ± 0,5 cm, p < 0,0001), während keine Unterschiede in den Diametern des Aortenbogens zu finden waren (2,3 ± 0,6 cm vs. 2,3 ± 0,4 cm, p = 0,69). Die Diameter der Aorta descendens waren bei den Patienten mit UAV geringfügig kleiner (2,2 ± 0,5 cm vs. 2,6 ± 0,3 cm, p < 0,05). Schlussfolgerung: Die Klappenmorphologie UAV kann mittels MRT sehr gut visualisiert werden. Bei allen Patienten mit UAV lag eine unikuspide unikommissurale Aortenklappe vor. Eine Dilatation der Aorta ascendens > 4,5 cm ist ein häufiges Phänomen der UAV. Bei diesen Patienten sollte die Aorta ascendens deshalb dringend mit dargestellt werden.
Abstract
Purpose: Congenitally malformed aortic valves are a common finding in adults with aortic valve disease. Most of these patients have bicuspid aortic valve disease. Unicuspid aortic valve disease (UAV) is rare. The aim of our study was to describe valve morphology and the dimensions of the proximal aorta in a cohort of 12 patients with UAV in comparison to tricuspid aortic valve disease (TAV) using magnetic resonance imaging (MRI). Materials and Methods/Results: MRI studies were performed on a 1.5 T scanner in a total of 288 consecutive patients with aortic valve disease. 12 aortic valves were retrospectively classified as UAV. Annulus areas and dimensions of the thoracic aorta were retrospectively compared to a cohort of 103 patients with TAV. In UAV, valve morphology was unicuspid unicommissural with a posterior commissure in all patients. Mean annulus areas and mean diameters of the ascending aorta were significantly greater in UAV compared to TAV (12.6 ± 4.7 cm2 vs. 8.7 ± 2.3 cm2, p < 0.01 and 4.6 ± 0.7 cm vs. 3.6 ± 0.5 cm, p < 0.0001, respectively), while no differences were observed in the mean diameters of the aortic arch (2.3 ± 0.6 cm vs. 2.3 ± 0.4 cm, p = 0.69). The diameters of the descending aorta were slightly smaller in UAV compared to TAV (2.2 ± 0.5 cm vs. 2.6 ± 0.3 cm, p < 0.05). Conclusion: In UAV, visualization of valve morphology by MRI is possible with good image quality. Valve morphology was classified as unicuspid unicommissural in all UAV patients. Dilatation of the proximal aorta > 4.5 cm is a frequent finding in UAV. Additional assessment of aortic dimensions is therefore recommended in patients with UAV.
Key words
aortic valve - aorta - heart
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Dr. Kurt Debl
Klinik und Poliklinik für Innere Medizin II, Universitätsklinikum Regensburg
Franz-Josef-Strauss-Allee 11
93053 Regensburg
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eMail: kurt.debl@klinik.uni-regensburg.de