What are the best tests to diagnose dissecting thoracic aortic aneurysm?
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Early, accurate diagnosis is important in the management of patients with a thoracic acute aortic dissection (AAD). A standardized prediction model can help to rapidly stratify patients into high, intermediate, and low pretest probabilities. In patients with a low probability of thoracic AAD, a negative D-dimer essentially rules out the condition. In patients with moderate or high pretest probabilities and in those with low risk but a positive D-dimer, transesophageal echocardiography (TEE), helical computed tomography (CT), and magnetic resonance imaging (MRI) all have a mean sensitivity and specificity of more than 95%. The decision of which imaging study to use, in most clinical situations, will be based on whichever test is immediately available.
Evidence Based Practice 12(8): 01-02.