A retrospective study was conducted at Royal Brompton and Harefield Hospitals, a tertiary cardiothoracic centre in London, involving two patient groups who underwent CT aortography. The first group included 44 patients with a confirmed diagnosis of MFS, all of whom underwent ECG-gated CT thoracic aortograms (as demonstrated by two examples in Fig.1)

Fig 1: References: Department of Radiology,Royal Brompton and Harefield Hospitals, London, UK 2025.

between 2010 to 2020, as part of their cardiovascular assessment. All Marfan patients in our study were on different medications to manage their blood pressure, and none had a bicuspid aortic valve. The second group comprised 35 individuals with no known aortic pathology who underwent an ECG-gated CT thoracic (as demonstrated by two examples in Fig.2)

Fig 2: References: Department of Radiology,Royal Brompton and Harefield Hospitals, London, UK 2025.

and abdominal aortogram between 2021 to 2023, for various clinical indications.

Normal aorta was defined as having a normal diameter with no arteriosclerosis or tortuosity. The scans were reviewed and confirmed as normal by an expert cardiothoracic consultant radiologist. 

Imaging was performed using either a cardiac-optimized 64-slice CT scanner or a dual-source flash scanner. A total of eight measurements were obtained from all scans using curved multiplanar reformatting (CMPR). The measurements in the Marfan patients were obtained from the first available preoperative CT thoracic aortogram.