男性，38岁。突发撕裂样胸背部痛伴大汗，心率100次/分，右上肢BP 100/60mmHg，左上 肢BP 150/70mmHg，听诊颈部血管杂音，胸骨左缘第3 ~4肋间叹气样舒张期杂音。心电图 示窦性心律，II、III、aVF导联T波倒置。X 线胸片示上纵隔稍宽。经服用硝酸甘油疼痛未 缓解。最可行而有价值的检查是

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