{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T06:35:26Z","timestamp":1793774126921,"version":"4.6.1"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T00:00:00Z","timestamp":1704844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute aortic dissection (AAD) is a life-threatening medical condition with high early fatality. Therefore, a prompt and precise diagnosis, which can be achieved through invasive and non-invasive techniques is vital. Echocardiography, unlike MRI and CT, is accessible in emergency units and bedside-compatible. The recommended echocardiographic techniques for AAD are transthoracic and transoesophageal echocardiography (TTE and TOE). Therefore, our review compares their diagnostic roles in AAD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Studies relevant to our topic were attained through a database search and manual scrutiny of references lists of articles obtained from the electronic databases. The Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2) has been used for quality assessment. All quantitative analyses were performed using either STATA 16 or Comprehensive Meta-Analyst software.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The search strategy yielded 1,798 articles, of which only 11 were eligible for inclusion. Our subgroup analysis showed that conventional TTE had a sensitivity and specificity of 85.35% and 84.51% for the diagnosis of Stanford type A AAD and was 45.89% sensitive and 87.05% specific for the diagnosis of type B AAD. However, the subgroup analysis shows that contrast-enhancement of TTE results in a sensitivity and specificity of 93.30% and 97.60% for diagnosis of type A AAD, and 83.60% and 94.50% for diagnosis of type B AAD, respectively. On the other hand, conventional TOE was 93.64% sensitive and 95.50% specific for the diagnosis of type A AAD, 99.80% sensitive and 99.87% specific for the diagnosis of type B AAD. Moreover, our analyses show that TTE has pooled false negative and positive rates of 28.6% and 18.6%, while TOE has shown false negative and positive rates of 2.4% and 4.3%, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>TOE is the more favorable diagnostic tool for AAD diagnosis than TTE. However, it cannot be used as a stand-alone diagnostic tool since misdiagnosis cases are being reported. Contrast-enhanced TTE can also diagnose AAD since it provides similar results to conventional TOE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2023.1283703","type":"journal-article","created":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T23:33:28Z","timestamp":1704843208000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Comparison between transthoracic echocardiography and transoesophageal echocardiography in the diagnosis of acute aortic dissection from an emergency perspective. A systematic review and meta-analysis"],"prefix":"10.3389","volume":"10","author":[{"given":"Hany A.","family":"Zaki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bilal","family":"Albaroudi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman E.","family":"Shaban","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baha Hamdi","family":"Alkahlout","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yavuz","family":"Yigit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wael","family":"Elnabawy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaleem","family":"Basharat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nood Dhafi","family":"Almarri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aftab Mohammad","family":"Azad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,1,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1642","DOI":"10.1053\/euhj.2001.2782","article-title":"Diagnosis and management of aortic dissection","volume":"22","author":"Erbel","year":"2001","journal-title":"Eur Heart J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1161\/CIRCULATIONAHA.110.958975","article-title":"Acute aortic dissection","volume":"122","author":"Braverman","year":"2010","journal-title":"Circulation"},{"key":"B3","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1001\/jama.283.7.897","article-title":"The international registry of acute aortic dissection (IRAD): new insights into an old disease","volume":"283","author":"Hagan","year":"2000","journal-title":"JAMA"},{"key":"B4","doi-asserted-by":"publisher","first-page":"2873","DOI":"10.1093\/eurheartj\/ehu281","article-title":"2014 ESC guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The task force for the diagnosis and treatment of aortic diseases of the European society of cardiology (ESC)","volume":"35","author":"Erbel","year":"2014","journal-title":"Eur Heart J"},{"key":"B5","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1093\/ejechocard\/jeq056","article-title":"Echocardiography in aortic diseases: EAE recommendations for clinical practice","volume":"11","author":"Evangelista","year":"2010","journal-title":"Eur J Echocardiogr"},{"key":"B6","doi-asserted-by":"publisher","first-page":"2702","DOI":"10.1161\/CIRCULATIONAHA.108.833004","article-title":"Diagnosis of acute aortic dissection by D-dimer: the international registry of acute aortic dissection substudy on biomarkers (IRAD-bio) experience","volume":"119","author":"Suzuki","year":"2009","journal-title":"Circulation"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1350","DOI":"10.1001\/archinte.166.13.1350","article-title":"Diagnostic accuracy of transesophageal echocardiography, helical computed tomography, and magnetic resonance imaging for suspected thoracic aortic dissection: systematic review and meta-analysis","volume":"166","author":"Shiga","year":"2006","journal-title":"Arch Intern Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1148\/radiology.199.2.8668776","article-title":"Aortic dissection: a comparative study of diagnosis with spiral CT, multiplanar transesophageal echocardiography, and MR imaging","volume":"199","author":"Sommer","year":"1996","journal-title":"Radiology"},{"key":"B9","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1016\/j.ahj.2011.09.022","article-title":"The role of transthoracic echocardiography in the diagnosis and management of acute type A aortic syndrome","volume":"163","author":"Cecconi","year":"2012","journal-title":"Am Heart J"},{"key":"B10","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1007\/s11739-014-1080-9","article-title":"Diagnostic performance of emergency transthoracic focus cardiac ultrasound in suspected acute type A aortic dissection","volume":"9","author":"Nazerian","year":"2014","journal-title":"Intern Emerg Med"},{"key":"B11","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1186\/s12947-015-0008-5","article-title":"Feasibility and accuracy of bedside transthoracic echocardiography in diagnosis of acute proximal aortic dissection","volume":"13","author":"Sobczyk","year":"2015","journal-title":"Cardiovasc Ultrasound"},{"key":"B12","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1186\/1756-0500-2-25","article-title":"Acute aortic dissection: be aware of misdiagnosis","volume":"2","author":"Asouhidou","year":"2009","journal-title":"BMC Res Notes"},{"key":"B13","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1093\/eurheartj\/ehp505","article-title":"Impact of contrast-enhanced echocardiography on the diagnostic algorithm of acute aortic dissection","volume":"31","author":"Evangelista","year":"2010","journal-title":"Eur Heart J"},{"key":"B14","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1161\/01.cir.85.2.434","article-title":"Diagnosis of thoracic aortic dissection. Magnetic resonance imaging versus transesophageal echocardiography","volume":"85","author":"Nienaber","year":"1992","journal-title":"Circulation"},{"key":"B15","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1007\/s10554-013-0290-y","article-title":"The role of contrast enhanced transesophageal echocardiography in the diagnosis and in the morphological and functional characterization of acute aortic syndromes","volume":"30","author":"Agricola","year":"2014","journal-title":"Int J Cardiovasc Imaging"},{"key":"B16","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1016\/0735-1097(96)00186-6","article-title":"Accuracy of biplane and multiplane transesophageal echocardiography in diagnosis of typical acute aortic dissection and intramural hematoma","volume":"28","author":"Keren","year":"1996","journal-title":"J Am Coll Cardiol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"603","DOI":"10.21037\/cdt-22-59","article-title":"Diagnostic performance of transthoracic echocardiography in screening acute type A aortic dissection from ST-segment elevated myocardial infarction","volume":"12","author":"Hui","year":"2022","journal-title":"Cardiovasc Diagn Ther"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1952","DOI":"10.1093\/eurheartj\/ehz207","article-title":"Integration of transthoracic focused cardiac ultrasound in the diagnostic algorithm for suspected acute aortic syndromes","volume":"40","author":"Nazerian","year":"2019","journal-title":"Eur Heart J"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.1016\/s0002-9149(02)02316-0","article-title":"Choice of computed tomography, transesophageal echocardiography, magnetic resonance imaging, and aortography in acute aortic dissection: international registry of acute aortic dissection (IRAD)","volume":"89","author":"Moore","year":"2002","journal-title":"Am J Cardiol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"A260","DOI":"10.1016\/0735-1097(91)92008-A","article-title":"Comparison of transesophageal and transthoracic echocardiography in acute aortic dissection. A multi-center prospective study","volume":"17","author":"Gu\u00e9ret","year":"1991","journal-title":"J Am Coll Cardiol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1016\/s0894-7317(98)70055-0","article-title":"Tissue harmonic imaging: why does it work?","volume":"11","author":"Thomas","year":"1998","journal-title":"J Am Soc Echocardiogr"},{"key":"B22","doi-asserted-by":"publisher","first-page":"821","DOI":"10.1053\/euhj.2001.2968","article-title":"Refinements in stress echocardiographic techniques improve inter-institutional agreement in interpretation of dobutamine stress echocardiograms","volume":"23","author":"Hoffmann","year":"2002","journal-title":"Eur Heart J"},{"key":"B23","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1002\/j.2205-0140.2012.tb00199.x","article-title":"Aortic plaque defined by contrast transthoracic echocardiography","volume":"15","author":"Cursaro","year":"2012","journal-title":"Australas J Ultrasound Med"},{"key":"B24","doi-asserted-by":"publisher","first-page":"S50","DOI":"10.1016\/j.ultrasmedbio.2017.08.1107","article-title":"The diagnostic value of contrast enhanced ultrasound in acute aortic dissection","volume":"43","author":"Lv","year":"2017","journal-title":"Ultrasound Med Biol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"R53","DOI":"10.1530\/ERP-18-0058","article-title":"The current role of echocardiography in acute aortic syndrome","volume":"6","author":"Evangelista","year":"2019","journal-title":"Echo Res Pract"},{"key":"B26","doi-asserted-by":"publisher","first-page":"i31","DOI":"10.1093\/ejechocard\/jen251","article-title":"Echocardiography in the emergency assessment of acute aortic syndromes","volume":"10","author":"Meredith","year":"2009","journal-title":"Eur J Echocardiogr"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1253","DOI":"10.1016\/0735-1097(89)90424-5","article-title":"Assessment of transesophageal Doppler echography in dissecting aortic aneurysm","volume":"14","author":"Hashimoto","year":"1989","journal-title":"J Am Coll Cardiol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"406","DOI":"10.1016\/j.jcmg.2013.10.015","article-title":"The role of imaging in aortic dissection and related syndromes","volume":"7","author":"Baliga","year":"2014","journal-title":"JACC Cardiovasc Imaging"},{"key":"B29","doi-asserted-by":"publisher","first-page":"S44","DOI":"10.4103\/0971-9784.192623","article-title":"Transesophageal echocardiography evaluation of the thoracic aorta","volume":"19","author":"Patil","year":"2016","journal-title":"Ann Card Anaesth"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2023.1283703\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T23:33:30Z","timestamp":1704843210000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2023.1283703\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,10]]},"references-count":29,"alternative-id":["10.3389\/fcvm.2023.1283703"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2023.1283703","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,10]]},"article-number":"1283703"}}