Heart size on chest x-ray as a predictor of cardiac enlargement by echocardiography in children

Pediatric Cardiology
G M SatouK J Jenkins

Abstract

To determine the usefulness of heart size on chest radiograph (CXR) in predicting cardiac enlargement (CE) in children, we prospectively evaluated 95 consecutive outpatients, who had both a CXR and echocardiography performed. Their median age was 5.0 years (2 days to 19.9 years). All patients underwent CXR assessment by a pediatric radiologist, with classification of cardiac silhouette as normal, borderline, or enlarged. Echocardiographic assessment of CE was performed by a pediatric echocardiographer. Sensitivity, specificity, and predictive values of the pediatric radiologist's interpretation of heart size on CXR were estimated. The presence of CE by echocardiography was used as the gold standard. Seventy-nine patients (83.2%) had no CE on CXR, and 16 patients (16.8%) had CE. Sensitivity of the CXR to identify CE was 58.8%, 95% confidence interval (CI) [32.9, 81.6], with a positive predictive value of 62.5% [35.4, 84.8]. Specificity was 92.3% [84.0, 97.1], with a negative predictive value of 91.1% [82.6, 96.4]. These data suggest that the assessment of CE on CXR to predict CE by echocardiography has a relatively high specificity and negative predictive value, but a low sensitivity and positive predictive value. The limitation...Continue Reading

Citations

Dec 24, 2005·Pediatric Cardiology·B FonsecaM S Sklansky
Mar 23, 2004·Archives of Disease in Childhood·Y C FuY Chang
Jan 6, 2010·Pediatrics in Review·Erin Madriago, Michael Silberbach
Nov 26, 2013·The Canadian Journal of Cardiology·Paul F KantorUNKNOWN Children's Heart Failure Study Group
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Jul 24, 2021·Veterinary Radiology & Ultrasound : the Official Journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association·Elodie E HuguetClifford R Berry

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