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Table 5 Main aortic imaging techniques

TTE/DUS TOE CCT CMR

Availability ++++ +++ ++ + Cost + ++ +++ ++++ Time requirement + +++ +++ ++++ Radiation 0 0 +++ 0 Spatial resolution 1 mm 1 mm 0.6 mm 1–2 mm Temporal resolution 20 msec 20 msec 80 msec 30 msec Nephrotoxicity 0 0 +++ + Accuracy ++ ++++ ++++ ++++ Serial examination ++++ ++ ++ ++++ Aortic wall visualization ++ +++ ++++ ++++ Aortic valve function +++ ++++ + ++++ RV/LV function +++ +++ +++a ++++ Aortic root assessment +++ +++ ++++ ++++ Aortic arch assessment ++ +++ ++++ ++++ Thoracic aorta assessment + ++ ++++ ++++ Abdominal aorta assessment +++ - ++++ ++++ © ESC 2024

CCT, cardiovascular computed tomography; CMR, cardiovascular magnetic resonance; LV, left ventricle; RV right ventricle; TOE, transoesophageal echocardiography; TTE, transthoracic echocardiography. aCCT can be used to evaluate left and right ventricular function only if retrospective gating is used.

A B C

D E F

AoR ASC

Figure 6 Conventional measurements of the aorta at different levels by echocardiography or duplex ultrasound (A, B, C), cardiovascular computed tomography or cardiovascular magnetic resonance (D, E, F). (A) Echocardiographic measurements of the aortic root and ascending aorta using the leading-to-leading edge methodology. (B) The outer-to-outer convention in the abdominal aorta in cases with aortic wall disease in a longitudinal view. This method can be used in a non-circular section as an alternative. (C) The outer-to-outer antero-posterior diameter of the abdominal aorta in a cross-sectional view. Evaluation of the aortic root using the cusp-to-cusp diameter (D) and the cusp-to-commissure convention (E); (F) measurement of the ascending aorta and the descending aorta with the double-oblique technique. AoR, aortic root; ASC, proximal ascending aorta. Downloaded from academic.oup.com/eurheartj/article/45/36/3538/7738955 by guest on 07 October 2026