Contrast-Enhanced Sonography for Diagnosis of Ruptured Abdominal Aortic Aneurysm

Abstract

We used contrast-specific sonography to assess eight patients with ruptured abdominal aortic aneurysm. Five of these cases were correlated with CT findings. We found that contrast-enhanced sonography can reveal features specific for ruptured aortic aneurysm without causing a significant delay in surgery. This technique may be as effective as CT but may allow a more rapid and noninvasive diagnosis, especially when sonography can be performed bedside.

Contrast enhanced ultrasonography versus MR angiography in aortocaval fistula: case report

“…A quick diagnosis is nevertheless crucial as surgical outcome is heavily influenced by the extent and duration of the preoperative hemodynamics and delayed surgery carries lower survival [2,3,9]. Operative mortality rates after repair of an aortocaval fistula range from 20% to 55%, with a two-thirds reduction if the diagnosis is known preoperatively [3].…”

“…Although the gold standard for detecting and characterizing aortocaval fistula today is CTA [12] and vascular ultrasound is often regarded as a second choice modality, many authors agree that subjects with typical symptoms should not undergo prolonged investigations and that urgent sonography should be the initial diagnostic step [9,13].…”

“…However, frequently complicating renal insufficiency seen in 11.8-33% of these patients discourages the use of iodinated contrast, making magnetic resonance angiography (MRA) a useful alternative [8,9]. In this case report, we describe our experience of prompt diagnosis of an abdominal aortic aneurysm complicated by an aortocaval fistula by bedside acquisition of contrast enhanced ultrasound (CEUS) in comparison to modern MRA.…”

Ultrasound in Abdominal Aortic Aneurysm

“…Although rupture of AAA could be indirectly diagnosed from clinical signs and symptoms and presence of an aneurysm, B-mode ultrasound can also reveal direct and indirect signs of rupture (Catalano & Siani, 2005a). Also, Catalano et al (2005b) further examined 8 ruptured AAA using contrast-enhanced ultrasound, concluding that contrast-enhanced ultrasound may be as effective as CT in detecting rupture, and does not delay surgery significantly. Further considerations on AAA emergency ultrasound can be found in Reardon et al (2008).…”

Radiological Imaging of Aortic Aneurysms

“…The ultrasonographic features of a ruptured aortic aneurysm are a delayed and longer luminal enhancement, a focal enhancement defect in the aortic wall, contrast media leakage through a mural thrombus and aortic wall, and periaortic accumulation of contrast media. 11) Transarterial aortography might be helpful for diagnosing an aortic aneurysm, but it is not useful for sizing an aortic aneurysm because aortography can reveal only luminal morphology without providing information on A: through the right common femoral artery, a 5-French catheter was inserted up to the proximal abdominal aorta and iodinated contrast media was injected during the repeated image acquisitions. The abdominal aortic aneurysm and its location could be identified, but the precise morphology and size of the aneurysm could not be depicted due to the obscure margin of contrast-filled lumen.…”