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Background: Three-dimensional (3D) echocardiography has been reported to be valuable for evaluating geometry for cardiac chambers. We validated the accuracy of 3D transthoracic echocardiography for quantifying aortic root geometry in comparison with cardiac multi-detector computed tomography (MDCT).Methods: Twenty-three patients with normal left ventricular ejection fraction (> 55%) as assessed by 2-dimensional transthoracic echocardiography, who underwent cardiac MDCT were enrolled (12 males, 53 ± 9 year-old). We defined the aortic root volume as the volume from aortic annulus to sinotubular junction. The aortic root volume at end-diastole by both cardiac MDCT and 3D echocardiography was assessed.Results: Cross-sectional area of aortic root formed asymmetric. At the level of annulus, cross-sectional area showed asymmetric triangle. From aortic annulus to the most dilated point of sinus of Valsalva, the asymmetric triangular shape was kept. From the most dilated point of sinus of Valsalva to sinotubular junction, the cross-sectional shape of aortic root changed oval. The average aortic root volumes measured by 3D echocardiography (ARV-3DE) was 13.6 ± 4.8 ml at end-diastole and 14.1 ± 5.3 ml at end-systole. The average aortic root volumes measured by MDCT (ARV-CT) was 14.1 ± 5.7 ml at end-diastole. The ARV-3DE at end-diastole correlated well with ARV-CT (R2 = 0.926, difference = 0.5 ± 1.7 ml, Figure 1). The ARV-3DE showed an excellent agreement with the ARVCT (% difference = 0%, Figure 1).Conclusion: Our results demonstrate the feasibility and accuracy of 3D echocardiography for clinical assessment of geometry for aortic root.