Difference between revisions of "Ultrasonography of abdominal aneurysm"

From radlines.org
Jump to navigation Jump to search
m (→‎Report: mm)
(→‎Report: +Mural thrombus, if present)
Line 22: Line 22:
 
*Any particular shape (other than fusiform).
 
*Any particular shape (other than fusiform).
 
*Aortic diameter, preferably as "in greatest diameter in the sagittal plane" or similar.
 
*Aortic diameter, preferably as "in greatest diameter in the sagittal plane" or similar.
 +
*Mural thrombus, if present
 
*Comparison to previous exams
 
*Comparison to previous exams
  

Revision as of 16:41, 2 January 2019

Author: Mikael Häggström [notes 1]

Abdominal aorta

Evaluation

Size classification of infrarenal aorta edit
Ectatic or
mild dilatation
>2.0 cm and <3.0 cm[1]
Moderate 3.0 - 5.0[1] (or 5.5)[2] cm
Large or severe >5.0[1] or 5.5[2] cm


The aortic measurement on abdominal ultrasonography is between the outer margins of the aortic wall.[3]

An aneurysm is usually defined as an outer aortic diameter over 3 cm (normal diameter of the aorta is around 2 cm),[4] or more than 50% of normal diameter.[5]

The proper projection of the aorta for measurement is the sagittal plane (solid line in image below), since the axial plane measurement (dashed line) may overestimate the diameter when the aorta is not parallel to the skin.

In case of an aortic aneurysm, determine the superior limit, preferably excluding possible para- or juxtarenal aortic aneurysm. The renal arteries may be seen by Doppler, but the branching points are often difficult to see.

Report

  • Location of aortic aneurysm, such as infrarenal, if the superior limit can be determined.
  • Any particular shape (other than fusiform).
  • Aortic diameter, preferably as "in greatest diameter in the sagittal plane" or similar.
  • Mural thrombus, if present
  • Comparison to previous exams

Example:

ri

Infrarenal saccular aortic aneurysm of 41 mm in gratest diameter in the sagittal plane (compared to 34 mm at previous exam on Nov 6, 2017)

Common iliac artery

Common iliac artery[6]
Normal Diameter ≤12 mm
Ectasia Diameter 12 to 18 mm
Aneurysm Diameter ≥18 mm


The common iliac arteries should be measured as well if requested, or if the patient is known to have an aneurysm of one or both common iliac arteries.

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.

References

  1. 1.0 1.1 1.2 . Archived copy. Archived from the original on 2017-09-08. Retrieved on 2017-08-23. Page 56] in: Philip Lumb (2014). Critical Care Ultrasound E-Book . Elsevier Health Sciences. ISBN 9780323278171. 
  2. 2.0 2.1 "Screening for abdominal aortic aneurysms: single centre randomised controlled trial ". BMJ 330 (7494): 750. Apr 2005. doi:10.1136/bmj.38369.620162.82. PMID 15757960. 
  3. Timothy Jang (2017-08-28). Bedside Ultrasonography Evaluation of Abdominal Aortic Aneurysm - Technique. Medscape. Archived from the original on 2018-01-25.
  4. "ACC/AHA Guidelines for the Management of Patients with Peripheral Arterial Disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Associations for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (writing committee to develop guidelines for the management of patients with peripheral arterial disease)—summary of recommendations ". J Vasc Interv Radiol 17 (9): 1383–97; quiz 1398. September 2006. doi:10.1097/01.RVI.0000240426.53079.46. PMID 16990459. 
  5. Solomon, Caren G.; Kent, K. Craig (2014). "Abdominal Aortic Aneurysms ". New England Journal of Medicine 371 (22): 2101–2108. doi:10.1056/NEJMcp1401430. ISSN 0028-4793. PMID 25427112. 
  6. Melissa L Kirkwood. Iliac artery aneurysm. Retrieved on 2018-02-23. Last updated: Mar 27, 2017.