Pediatric patients with Marfan Syndrome: frequency of dural ectasia and its correlation with common cardiovascular manifestations
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Pediatric patients with Marfan Syndrome: frequency of dural ectasia and its correlation with common cardiovascular manifestations. / Veldhoen, S; Stark, V; Müller, Götz; Derlin, T; Bley, T A; Weil, J; Kodolitsch, Yskert; Mir, T S.
in: ROFO-FORTSCHR RONTG, Jahrgang 186, Nr. 1, 01.01.2014, S. 61-6.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Pediatric patients with Marfan Syndrome: frequency of dural ectasia and its correlation with common cardiovascular manifestations
AU - Veldhoen, S
AU - Stark, V
AU - Müller, Götz
AU - Derlin, T
AU - Bley, T A
AU - Weil, J
AU - Kodolitsch, Yskert
AU - Mir, T S
N1 - © Georg Thieme Verlag KG Stuttgart · New York.
PY - 2014/1/1
Y1 - 2014/1/1
N2 - PURPOSE: Marfan syndrome (MFS) is a genetic disorder of the connective tissue. Aortic root dilation is a main criterion of the Ghent Nosology. Dural ectasia and the presence of mitral valve prolapse (MVP) contribute to its systemic score. The purpose of this study was to investigate the frequency of dural ectasia and its correlation with cardiovascular manifestations in a pediatric study population.PATIENTS AND METHODS: 119 pediatric patients with confirmed or suspected MFS were examined in the local Marfan Clinic. 31 children with MFS who underwent magnetic resonance imaging (MRI) were included. Each patient was evaluated according to the Ghent nosology. Echocardiography was used to measure the aortic root diameter and assess the presence of MVP and mitral regurgitation. Z-scores were calculated for the evaluation of the aortic root diameters. MRI was performed to determine the dural sac ratio (DSR).RESULTS: The prevalence of dural ectasia was 90.3 %, of aortic root dilation 32.2 %, of MVP 64.5 % and of mitral regurgitation 51.6 %. DSR at L5 correlated with the intraindividual z-scores (slope, 3.62 ± 1.5 [0.56; 6.68]; r = 0.17; p = 0.02; F = 5.84). Z-scores ≥ 2 were accompanied by dural ectasia in 100 %, MVP in 95 % and mitral regurgitation in 100 % of cases. MVP was accompanied by mitral regurgitation in 70 % of cases.CONCLUSION: As the examined cardiac manifestations show a coincidence with dural ectasia in 95 - 100 % of cases, MRI for diagnostic dural sac imaging should be reserved for MFS suspicions with the absence of those manifestations in order to establish the diagnosis according to the Ghent criteria. Thus, the present study supports the recent downgrading of dural ectasia to a contributor to the systemic score.
AB - PURPOSE: Marfan syndrome (MFS) is a genetic disorder of the connective tissue. Aortic root dilation is a main criterion of the Ghent Nosology. Dural ectasia and the presence of mitral valve prolapse (MVP) contribute to its systemic score. The purpose of this study was to investigate the frequency of dural ectasia and its correlation with cardiovascular manifestations in a pediatric study population.PATIENTS AND METHODS: 119 pediatric patients with confirmed or suspected MFS were examined in the local Marfan Clinic. 31 children with MFS who underwent magnetic resonance imaging (MRI) were included. Each patient was evaluated according to the Ghent nosology. Echocardiography was used to measure the aortic root diameter and assess the presence of MVP and mitral regurgitation. Z-scores were calculated for the evaluation of the aortic root diameters. MRI was performed to determine the dural sac ratio (DSR).RESULTS: The prevalence of dural ectasia was 90.3 %, of aortic root dilation 32.2 %, of MVP 64.5 % and of mitral regurgitation 51.6 %. DSR at L5 correlated with the intraindividual z-scores (slope, 3.62 ± 1.5 [0.56; 6.68]; r = 0.17; p = 0.02; F = 5.84). Z-scores ≥ 2 were accompanied by dural ectasia in 100 %, MVP in 95 % and mitral regurgitation in 100 % of cases. MVP was accompanied by mitral regurgitation in 70 % of cases.CONCLUSION: As the examined cardiac manifestations show a coincidence with dural ectasia in 95 - 100 % of cases, MRI for diagnostic dural sac imaging should be reserved for MFS suspicions with the absence of those manifestations in order to establish the diagnosis according to the Ghent criteria. Thus, the present study supports the recent downgrading of dural ectasia to a contributor to the systemic score.
KW - Adolescent
KW - Cardiovascular Diseases
KW - Child
KW - Child, Preschool
KW - Comorbidity
KW - Dura Mater
KW - Female
KW - Germany
KW - Humans
KW - Incidence
KW - Infant
KW - Magnetic Resonance Imaging
KW - Male
KW - Marfan Syndrome
KW - Reproducibility of Results
KW - Risk Factors
KW - Sensitivity and Specificity
KW - Statistics as Topic
U2 - 10.1055/s-0033-1350421
DO - 10.1055/s-0033-1350421
M3 - SCORING: Journal article
C2 - 24043612
VL - 186
SP - 61
EP - 66
JO - ROFO-FORTSCHR RONTG
JF - ROFO-FORTSCHR RONTG
SN - 1438-9029
IS - 1
ER -