Accuracy of two-dimensional echocardiography in diagnosis of aortic dissection

The usefulness of transthoracic and transabdominal two-dimensional echocardiography (2-D echo) in patients who presented with dilated aorta with or without acute chest pain and/or abdominal pain was assessed for diagnosis of aortic dissection (AD) both acute and chronic forms. The criterion for diagnosis of AD was the constant appearance of undulating motion of abnormal linear echo in the aortic lumen in more than one scan plane. During a 4-year period (1984-1988), a prospective analysis of 16 patients was carried out and the result disclosed that 11 had AD (6 in acute AD, 5 in chronic AD) while the other 5 did not have AD. 2-D echo findings were diagnostic of De Bakey Type I in 7 patients, Type II in one, Type III in two, false negative Type I in one, and true negative in the remaining five. Therefore, the sensitivity was 91 per cent and the positive predictive value was 100 per cent. Thus, our data indicates that 2-D echo is a reliable non-invasive method for diagnosis of AD in either the acute or chronic form and proximal or distal AD.