The aim of this work was to quantify the spread between results of two views CXRs (chest X-rays) and angio-CTs (CTA) in the evaluation of thoracic aorta calcific atherosclerosis (TACC) and/or enlargement.
Methods and Materials
We retrospectively analyzed 18 subjects (15 males,
3 females; age range between 55 and 86,
mean 74 years) who underwent both a two views CXR (posteroanterior and lateral views) and a CTA within 365 days from each other.
An exemplifying case,
which compares CXR and CTA views,
is shown in Fig.1.
The sample size is relatively small because CTAs including thoracic aorta permit to examine lung parenchyma and other chest structures as well,
so it is uncommon to require a CXR if a CTA is...
Enlargement detection differed significantly statistically between CXR and CTA,
whereas TACC detection did not.
Kappa statistic showed acceptable agreement for TACC detection and virtually non-existent agreement for enlargement detection.
Specificity was high in both evaluations and this could be explained considering that when those radiological findings are evident in CXR it might be because of their relatively relevant size.
Summary of results for TACC and enlargement are showed in Fig.
2 and Fig.
Our study results showed that CXR performed well compared to CTA in the detection of TACC,
while performed poorly in the detection of its enlargement,
but it showed high specificity in both evaluations.
Calcification are often evident in CXR because of their radiopacity,
even if their extension is not very large; on the other hand,
three-dimensional aorta enlargement has to be pictured on a 2D image which makes its detection somewhat harder,
especially when its enlargement is relatively small in size.
References and further readings:
• Bucek RA,
et al (2002) Die Rolle des Thoraxröntgens in der Diagnose des thorakalen Aortenaneurysmas.
RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren 174:600–604.
• Elbey M,
Sevimli S (2008) Emergency Surgical Treatment of a Giant Unruptured Aneurysm of the Ascending Aorta: The Importance of Routine Chest X‐Ray.
The Thoracic and Cardiovascular Surgeon 56:112–113.
• Hashimoto H,
et al (2009) Validity and Usefulness of...