What is the role of chest radiography in the workup of thoracic aortic aneurysm (TAA)?

Updated: Apr 02, 2021
  • Author: Elaine Tseng, MD; Chief Editor: Mary C Mancini, MD, PhD, MMM  more...
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In the case of ascending aortic aneurysms, chest x-rays may reveal a widened mediastinum (see the image below), a shadow to the right of the cardiac silhouette, and convexity of the right superior mediastinum. Lateral films demonstrate loss of the retrosternal air space. However, the aneurysms may also be completely obscured by the heart, and the chest x-ray appear normal.

Chest radiograph showing widening of superior medi Chest radiograph showing widening of superior mediastinum.

Plain chest radiographs may show a shadow anteriorly and slightly to the left for arch aneurysms and posteriorly and to the left for descending thoracic aneurysms. Aortic calcification may outline the borders of the aneurysm in the anterior, posterior, and lateral views in both the chest and abdomen.

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