Chest radiography for the diagnosis of XXXX .

@entity1 @entity697 @entity548 @entity1066 @entity1410 @entity439 @entity2333
PURPOSE: We sought to assess the diagnostic accuracy of routine chest radiography for the @entity697 (dissection, intramural @entity1410 , penetrating @entity1066 , or nondissecting @entity439 ). METHODS: During a 6-year period, 216 @entity1 (143 @entity1 , 73 @entity1 ; mean [+/- SD] age, 58 +/- 17 years) underwent chest radiography for suspected @entity697 . Chest films were re-evaluated blindly for @entity2333 , based on an overall impression using standard criteria such as widening of the aortic contour and mediastinal shadow. Findings were matched to tomographic images, anatomical inspection, or both, as the criterion standard; @entity2333 was confirmed in 109 (50%) of the @entity1 . RESULTS: Chest radiography had a sensitivity of 64% (70/109) and a specificity of 86% (92/107) for @entity2333 . Sensitivity was 67% (38/57) for overt aortic dissection, 61% (22/36) for nondissecting @entity439 , and 63% (10/16) for @entity548 or penetrating @entity1066 . However, sensitivity was lower for pathology confined to the proximal aorta (47% [21/45]) than for disease involving distal aortic segments (77% [49/64]). A receiver operating characteristic curve analysis of aortic diameters failed to identify a threshold for the diagnosis of @entity2333 . CONCLUSION: Chest radiography is of limited value for diagnosing the @entity697 , particularly for conditions confined to the ascending aorta. Since a definitive diagnosis is required in any @entity1 with clinically suspected @entity697 , routine chest radiography should be replaced by tomographic aortic imaging.
