Most commonly, a widened mediastinum is appreciated in patients with pathology extending to the proximal to mid thoracic aorta, and a posteroanterior (PA) projection is found to be significantly more accurate than an anteroposterior (AP) projection [53]. Other studies have found that a chest radiograph is not sensitive (64%) or specific (87%) for thoracic aortic disease [54,55]. Given the relatively low sensitivity and specificity, chest radiography should not substitute for cross-sectional imaging. Furthermore, the role of chest radiography in the follow-up of known thoracoabdominal disease is limited because radiographs would be unlikely to appreciate subtle changes in aortic size. Radiography Chest, Abdomen, and Pelvis There is no relevant literature for chest, abdomen, and pelvis radiographs for the follow-up of thoracoabdominal aortic dissection or aneurysm. Chest radiographs demonstrate abnormalities in a large percentage of patients with acute thoracoabdominal pathology. Most commonly, a widened mediastinum is appreciated in patients with pathology extending to the proximal to mid thoracic aorta, and a PA projection is found to be significantly more accurate than an AP projection [53]. Other studies have found that a chest radiograph is not sensitive (64%) or specific (87%) for thoracic aortic disease [54,55]. Given the relatively low sensitivity and specificity, chest radiography should not substitute for cross-sectional imaging. Furthermore, the role of chest radiography in the follow-up of known thoracoabdominal disease is limited because radiographs would be unlikely to appreciate subtle changes in aortic size. US Duplex Doppler Aorta Abdomen Duplex ultrasound (US) of the abdominal aorta is an option for evaluation of the thoracoabdominal aorta, although the ability to evaluate the aorta above the diaphragm may be markedly limited by acoustic windows.
Thoracoabdominal Aneurysm or Dissection Treatment Planning and Follow Up. Most commonly, a widened mediastinum is appreciated in patients with pathology extending to the proximal to mid thoracic aorta, and a posteroanterior (PA) projection is found to be significantly more accurate than an anteroposterior (AP) projection [53]. Other studies have found that a chest radiograph is not sensitive (64%) or specific (87%) for thoracic aortic disease [54,55]. Given the relatively low sensitivity and specificity, chest radiography should not substitute for cross-sectional imaging. Furthermore, the role of chest radiography in the follow-up of known thoracoabdominal disease is limited because radiographs would be unlikely to appreciate subtle changes in aortic size. Radiography Chest, Abdomen, and Pelvis There is no relevant literature for chest, abdomen, and pelvis radiographs for the follow-up of thoracoabdominal aortic dissection or aneurysm. Chest radiographs demonstrate abnormalities in a large percentage of patients with acute thoracoabdominal pathology. Most commonly, a widened mediastinum is appreciated in patients with pathology extending to the proximal to mid thoracic aorta, and a PA projection is found to be significantly more accurate than an AP projection [53]. Other studies have found that a chest radiograph is not sensitive (64%) or specific (87%) for thoracic aortic disease [54,55]. Given the relatively low sensitivity and specificity, chest radiography should not substitute for cross-sectional imaging. Furthermore, the role of chest radiography in the follow-up of known thoracoabdominal disease is limited because radiographs would be unlikely to appreciate subtle changes in aortic size. US Duplex Doppler Aorta Abdomen Duplex ultrasound (US) of the abdominal aorta is an option for evaluation of the thoracoabdominal aorta, although the ability to evaluate the aorta above the diaphragm may be markedly limited by acoustic windows.