Diagnostic utility of unenhanced computed tomography for acute aortic syndrome.
Circ J
; 78(8): 1928-34, 2014.
Article
em En
| MEDLINE
| ID: mdl-24909890
ABSTRACT
BACKGROUND:
The diagnostic value of unenhanced computed tomography (CT) for diagnosing acute aortic dissection (AAD) and ruptured thoracic aortic aneurysm (TAA) remains unclear. METHODS ANDRESULTS:
We examined 219 consecutive patients who visited the emergency room with suspected acute aortic syndrome (AAS) because of chest or back pain and who underwent both unenhanced and contrast-enhanced 64-row multi-detector CT. The unenhanced CT findings were evaluated by the cardiologist on duty who was blind to the findings of contrast-enhanced CT. Diagnosis of AAS was confirmed in 103 patients (47%, 95 AAD and 8 ruptured TAA patients) based on evaluation of both unenhanced and contrast-enhanced CT images, which was used as the reference standard for validating the diagnostic value of the unenhanced CT findings. Sensitivity and specificity of the findings of a high-attenuation crescent, which represents hematoma in the aortic wall, were 61.2% and 99.1%, respectively. Sensitivity and specificity of linear high density in the aorta, which represents an intimal flap, were 59.2% and 96.6%, respectively. If unenhanced CT showed none of high-attenuation crescent, linear high density, internal displacement of intimal calcification, or TAA, the negative predictive value was 93.3%.CONCLUSIONS:
Unenhanced CT is a good tool for ruling AAS in, but the false-negative rate of 6.7% is high for ruling AAS out because it has to be the minimum possible.
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Base de dados:
MEDLINE
Assunto principal:
Ruptura Aórtica
/
Aortografia
/
Tomógrafos Computadorizados
/
Serviços Médicos de Emergência
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article