Disección aórtica: verdadero valor diagnóstico de la radiografía de tórax

Abstract

objective: To evaluate the diagnostic capacity of the radiological signs for aortic dissection (AD) and their applicability for the diagnosis, as well as to establish a cut-off value for left mediastinal width in AD and determine its sensitivity (S) and spe-cificity (E). Method: From a high complexity cardiovascular institute, 39 patients were selected and chest X-rays were perfor-med from August 1, 2018 to February 1, 2019. Selection criteria involved those who underwent computed tomography angio-graphy of thoracic aorta for clinical suspicion of AD. results: Within the sample, 72% were men (mean 63 years old), with hypertension as a most common risk factor. 43% of the patient had AD, 76% were type B. The mean maximum mediastinal width showed a difference of 1.5 cm between patients with AD and those without it. In contrast, the difference was 2 cm for the left mediastinal width. Maximum mediastinal width and left mediastinal width were statistically significant signs. Left mediastinal width presented good diagnostic capacity (area under the curve: 0.84). Cut-off point of 5.39 cm for the left mediastinal width was calculated (S: 82%; E: 77%). Finally, widening of the aortic knob, ascending/descending aorta or asymmetry between both showed to be statistically significant signs. Conclusions: Radiological signs for the diagnosis of AD was vali-dated. Also, a cut-off point for the left mediastinal width of 5.39 cm was found with a very good diagnostic capacity.