Voir la source de PS:Dissection aortique (diagnostic)



== Algorithme ==

[[File:DAo ddimeres.png|upright|DAo ddimeres.png]]

== Evaluation du risque ==

[[File:DAo risque.png|upright|DAo risque.png]]
== SPEED protocol ==


Utilisation de l'ECMU : Le protocole SPEED combine l'échocardiographie transthoracique et l'échographie de l'aorte abdominale.
=== Cible : ===

*dissection aortique de type A de Standford
***épanchement péricardique,
***un flap intimal
***un diamètre de l'aorte initial (AOFT) &gt; 35 mm mesuré d'une paroi interne à l'autre à 20 mm de l'anneau aortique en fin de diastole<br>
*dissection aortique de type B de Standford
***un flap intimal dans l'aorte abdominale

=== valeur du test ===
{| class="table article-section__table"<thead>
|-
| class="bottom-bordered-cell right-bordered-cell left-aligned" style="width: 80px;" |
! class="bottom-bordered-cell left-aligned" style="width: 213px;" | A-AoD and B-AoD (95% CI)
! class="bottom-bordered-cell left-aligned" style="width: 126px;" | A-AoD (95% CI)
! class="bottom-bordered-cell left-aligned" style="width: 276px;" | B-AoD (intimal flap only) (95% CI)</thead>
|-
| class="right-bordered-cell left-aligned" style="width: 80px;" | Accuracy
| class="left-aligned" style="width: 213px;" | 91 (89.3–92.5)
| class="left-aligned" style="width: 126px;" | 91.1 (89.4–92.6)
| class="left-aligned" style="width: 276px;" | 99.8 (99.3–100)
|-
| class="right-bordered-cell left-aligned" style="width: 80px;" | Sensitivity
| class="left-aligned" style="width: 213px;" | 93.2 (81.3–98.6)
| class="left-aligned" style="width: 126px;" | 100 (83.9–100)
| class="left-aligned" style="width: 276px;" | 87 (66.4–97.2)
|-
| class="right-bordered-cell left-aligned" style="width: 80px;" | Specificity
| class="left-aligned" style="width: 213px;" | 90.9 (89.2–92.5)
| class="left-aligned" style="width: 126px;" | 90.9 (89.2–92.5)
| class="left-aligned" style="width: 276px;" | 100 (99.7–100)
|-
| class="right-bordered-cell left-aligned" style="width: 80px;" | PPV
| class="left-aligned" style="width: 213px;" | 26.3 (19.6–33.9)
| class="left-aligned" style="width: 126px;" | 15.4 (9.8–22.6)
| class="left-aligned" style="width: 276px;" | 100 (83.2–100)
|-
| class="right-bordered-cell left-aligned" style="width: 80px;" | NPV
| class="left-aligned" style="width: 213px;" | 99.7 (99.2–100)
| class="left-aligned" style="width: 126px;" | 100 (99.7–100)
| class="left-aligned" style="width: 276px;" | 99.8 (99.3–100)
|-
| class="right-bordered-cell left-aligned" style="width: 80px;" | '''PLR'''
| class="left-aligned" style="width: 213px;" | 10.2 (8.5–12.5)
| class="left-aligned" style="width: 126px;" | 11 (9.3–13.2)
| class="left-aligned" style="width: 276px;" | Undefined
|-
| class="right-bordered-cell left-aligned" style="width: 80px;" | '''NLR'''
| class="left-aligned" style="width: 213px;" | 0.1 (0.0–0.2)
| class="left-aligned" style="width: 126px;" | Undefined
| class="left-aligned" style="width: 276px;" | 0.1 (0.1–0.4)
|}

== Référence ==

[[File:Pdf.jpeg|Pdf.jpeg|link=]]&nbsp;[[Media:DAo_canadian_rules.pdf|Diagnosing acute aortic syndrome: a Canadian clinical practice guideline]]&nbsp; CMAJ2020&nbsp; doi: 10.1503/cmaj.200021

[[File:Pdf.jpeg|Pdf.jpeg|link=]]&nbsp; The sonographic protocol for the emergent evaluation of aortic dissections (SPEED protocol): A multicenter, prospective, observational study&nbsp; AEM 2023 &nbsp;[https://doi.org/10.1111/acem.14839 https://doi.org/10.1111/acem.14839]<br>
== Mise à jour&nbsp;: Juillet 2024 ==

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