Clinicians often encounter discrepant measurements of the ascending 
aorta that impede, complicate, and impair appropriate clinical 
assessment—including key issues of presence or absence of aortic growth,
 rate of growth, and need for surgical intervention. These discrepancies
 may arise within a single modality (computed tomography scan, magnetic 
resonance imaging, or echocardiography) or between modalities. The 
authors explore the origins and significance of these discrepancies, 
revealing that some “truth” usually underlies all the discrepant 
measurements, which individually look at the ascending aorta with 
different perspectives and dimensional definitions. The authors conclude
 with a practical “question and answer” section that addresses common 
specific issues in interpretation and management of patients in the 
real-world setting.