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Article: Diagnostic accuracy of mediastinal width measurement on posteroanterior and anteroposterior chest radiographs in the depiction of acute nontraumatic thoracic aortic dissection

TitleDiagnostic accuracy of mediastinal width measurement on posteroanterior and anteroposterior chest radiographs in the depiction of acute nontraumatic thoracic aortic dissection
Authors
KeywordsAcute aortic dissection
Chest radiograph
Computed tomography
Nontraumatic
Issue Date2012
PublisherSpringer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/10140/index.htm
Citation
Emergency Radiology, 2012, v. 19 n. 4, p. 309-315 How to Cite?
AbstractWe aimed to explore the diagnostic accuracy of various mediastinal measurements in determining acute nontraumatic thoracic aortic dissection with respect to posteroanterior (PA) and anteroposterior (AP) chest radiographs, which had received little attention so far. We retrospectively reviewed 100 patients (50 PA and 50 AP chest radiographs) with confirmed acute thoracic aortic dissection and 120 patients (60 PA and 60 AP chest radiographs) with confirmed normal aorta. Those who had prior history of trauma or aortic disease were excluded. The maximal mediastinal width (MW) and maximal left mediastinal width (LMW) were measured by two independent radiologists and the mediastinal width ratio (MWR) was calculated. Statistical analysis was then performed with independent sample t test. PA projection was significantly more accurate than AP projection, achieving higher sensitivity and specificity. LMW and MW were the most powerful parameters on PA and AP chest radiographs, respectively. The optimal cutoff levels were LMW = 4.95 cm (sensitivity, 90 %; specificity, 90 %) and MW = 7.45 cm (sensitivity, 90 %; specificity, 88.3 %) for PA projection and LMW = 5.45 cm (sensitivity, 76 %; specificity, 65 %) and MW = 8.65 cm (sensitivity, 72 %; specificity, 80 %) for AP projection. MWR was found less useful and less reliable. The use of LMW alone in PA film would allow more accurate prediction of aortic dissection. PA chest radiograph has a higher diagnostic accuracy when compared with AP chest radiograph, with negative PA chest radiograph showing less probability for aortic dissection. Lower threshold for proceeding to computed tomography aortogram is recommended however, especially in the elderly and patients with widened mediastinum on AP chest radiograph. © 2012 The Author(s).
Persistent Identifierhttp://hdl.handle.net/10722/145887
ISSN
2015 SCImago Journal Rankings: 0.523

 

DC FieldValueLanguage
dc.contributor.authorLai, Ven_HK
dc.contributor.authorTsang, WKen_HK
dc.contributor.authorChan, WCen_HK
dc.contributor.authorYeung, TWen_HK
dc.date.accessioned2012-03-27T09:00:36Z-
dc.date.available2012-03-27T09:00:36Z-
dc.date.issued2012en_HK
dc.identifier.citationEmergency Radiology, 2012, v. 19 n. 4, p. 309-315en_HK
dc.identifier.issn1070-3004en_HK
dc.identifier.urihttp://hdl.handle.net/10722/145887-
dc.description.abstractWe aimed to explore the diagnostic accuracy of various mediastinal measurements in determining acute nontraumatic thoracic aortic dissection with respect to posteroanterior (PA) and anteroposterior (AP) chest radiographs, which had received little attention so far. We retrospectively reviewed 100 patients (50 PA and 50 AP chest radiographs) with confirmed acute thoracic aortic dissection and 120 patients (60 PA and 60 AP chest radiographs) with confirmed normal aorta. Those who had prior history of trauma or aortic disease were excluded. The maximal mediastinal width (MW) and maximal left mediastinal width (LMW) were measured by two independent radiologists and the mediastinal width ratio (MWR) was calculated. Statistical analysis was then performed with independent sample t test. PA projection was significantly more accurate than AP projection, achieving higher sensitivity and specificity. LMW and MW were the most powerful parameters on PA and AP chest radiographs, respectively. The optimal cutoff levels were LMW = 4.95 cm (sensitivity, 90 %; specificity, 90 %) and MW = 7.45 cm (sensitivity, 90 %; specificity, 88.3 %) for PA projection and LMW = 5.45 cm (sensitivity, 76 %; specificity, 65 %) and MW = 8.65 cm (sensitivity, 72 %; specificity, 80 %) for AP projection. MWR was found less useful and less reliable. The use of LMW alone in PA film would allow more accurate prediction of aortic dissection. PA chest radiograph has a higher diagnostic accuracy when compared with AP chest radiograph, with negative PA chest radiograph showing less probability for aortic dissection. Lower threshold for proceeding to computed tomography aortogram is recommended however, especially in the elderly and patients with widened mediastinum on AP chest radiograph. © 2012 The Author(s).en_HK
dc.languageengen_US
dc.publisherSpringer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/10140/index.htmen_HK
dc.relation.ispartofEmergency Radiologyen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subjectAcute aortic dissectionen_HK
dc.subjectChest radiographen_HK
dc.subjectComputed tomographyen_HK
dc.subjectNontraumaticen_HK
dc.titleDiagnostic accuracy of mediastinal width measurement on posteroanterior and anteroposterior chest radiographs in the depiction of acute nontraumatic thoracic aortic dissectionen_HK
dc.typeArticleen_HK
dc.identifier.emailLai, V:laiv@hku.hken_HK
dc.identifier.authorityLai, V=rp01516en_HK
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1007/s10140-012-1034-3en_HK
dc.identifier.pmid22415593-
dc.identifier.scopuseid_2-s2.0-84865146539en_HK
dc.identifier.hkuros199103en_US
dc.identifier.volume19-
dc.identifier.issue4-
dc.identifier.spage309en_HK
dc.identifier.epage315en_HK
dc.identifier.eissn1438-1435-
dc.publisher.placeGermanyen_HK
dc.identifier.scopusauthoridLai, V=15829844300en_HK
dc.identifier.scopusauthoridTsang, WK=55069233000en_HK
dc.identifier.scopusauthoridChan, WC=55067727500en_HK
dc.identifier.scopusauthoridYeung, TW=37114944900en_HK
dc.identifier.citeulike10468691-

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