Vol 7: Special Issue 2012:S1-S4 |
Comparison of sensitivity and specificity of cardiac size estimation through plain chest x-rayand two ecocardiography
Abstract
BACKGROUND: Despite more accurate methods of cardiac imaging, plain chest X-ray (CXR)
still is the first imaging method in people with suspected heart diseases. The most important
application of CXR in cardiac patients is the estimation of cardiac size. There are two main
methods for cardiac estimation in CXR; transverse diameter (TD) and calculation of cardiac
width ratio to thoracic cage or cardiothoracic ratio (CTR). Echocardiography is a standard and
more accurate method for cardiac size measurement; however, it requires more time and is
costly,and is not as accessibleas CXR.
METHODS: This study aimed to determine the sensitivity and specificity of CXR to diagnose
enlarged heart (cardiomegaly) in comparison with echocardiography. In this study, 327 adults
that referred for echocardiography to Hajar Hospital(Shahrekord, Iran) during summer 2001
were recruited. Their CXR findings were compared to echocardiography.
RESULTS: Mean age of the patients was 53.6 years and 46% were male. Considering the CTR ≤
50% of thoracic cage widthand TD ≤ 16 cm as normal,CTR resulted in 28.2% false-positiveand
9.2% false-negative classification for cardiomegaly.The corresponding figures for TD were
8.8%and 58.5%, respectively.
CONCLUSION: In order to determine cardiomegaly, CTR had a higher sensitivity in
comparison with TD; however, the specificity of TD was higher than CXR.
Keywords: Echocardiography, Plain Chest X-Ray, Cardiac Size.
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