Increased aortic wall thickness for the diagnosis of aortitis: a computed tomography-based study

AimsTo evaluate the usefulness of computed tomography (CT)-measured aortic wall thickness (AWT) as a sole imaging finding for the confirmation of clinically suspected aortitis. MethodsCT scans of 20 patients with the diagnosis of aortitis, endorsed by the abnormally thickened aortic wall, as a single imaging finding, and 250 patients without known aortitis were reviewed and AWT manually measured at the levels of thoracic descending aorta, upper abdominal aorta and infrarenal aorta, as well as the level of maximal AWT in patients with diagnosed aortitis. Patients' charts were analyzed and demographic data and data on co-morbidities extracted. Correlations of measured AWT with patients' demographic data and co-morbidities were calculated for the control patients. Age-dependent upper 97.5 percentile points for AWT were calculated for different age groups as a reference. AWT of patients, diagnosed with aortitis, was compared with these reference values. ResultsAWT had significant positive correlation with patient age (P < 0.001), gender (P < 0.03) and presence of aortic wall calcifications (P < 0.001). In nine of 20 patients, with diagnosed aortitis confirmed by the increased CT-measured AWT, the revised values of AWT were lower than the calculated upper 97.5 percentile points for the relevant age group. In four of these patients, the values of the measured AWT were in the range of mean + SD for AWT for the same age. ConclusionsThe confirmation of suspected aortitis by the increased CT-measured AWT only may be equivocal and necessitate more specific imaging, particularly in elderly patients.