Comparison of mediastinal width, mediastinal-thoracic and -cardiac ratios, and “mediastinal widening” in detection of traumatic aortic rupture

Diagnostic accuracy of mediastinal width measurement on posteroanterior and anteroposterior chest radiographs in the depiction of acute nontraumatic thoracic aortic dissection

“…These included widening of the mediastinum, blurring of the aortic knob or aortic knob width, tracheal shifting to the right, left apical cap, depression of the left mainstem bronchus below 40°, widened left paraspinal line, abnormal MW–chest width ratio, hemothorax, pneumothorax, and rib fractures [14–18]. MW >8 cm had been a widely used screening tool for aortic rupture [19–21]. However, only little emphasis was made on acute nontraumatic aortic rupture and aortic dissection.…”

Left Mediastinal Width and Mediastinal Width Ratio Are Better Radiographic Criteria Than General Mediastinal Width for Predicting Blunt Aortic Injury

“…The most widely used of these four radiographic signs for TAI is increased mediastinal width, with 8 cm considered abnormal. 4 However, mediastinal widening as a radiographic sign of TAI has been deemphasized in some literatures. [13][14][15] The positive predictive value of chest radiography using mediastinal widening as a sign of TAI, especially in a trauma setting, is approximately 5% to 20% in most series.…”

Blunt and penetrating chest injuries

“…Patients then with a mechanism of injury that could produce such an injury should have a chest film examined closely for the presence of the eight factors noted as being associated with such an injury: Almost every study cites the presence of some mediastinal abnormality such as mediastinal widening, deviation of trachea or esophagus, or aortic knob blurring as almost universally present [28][29][30]. We recently had a patient whose only injury present on chest radiograph, even in retrospect, was a fractured first rib.…”