Radiological Imaging of Aortic Aneurysms

Abstract

The development of radiological equipment such as MDCT or ultrasonography has increased the diagnostic accuracy of aortic aneurysms and has allowed for improvements in surgical and interventional treatment techniques. However, the mortality and morbidity rate of aortic aneurysms has not decreased significantly. For this reason, there is continuous interest in radiological evaluations of aortic aneurysms. This report reviews the radiological image findings and useful indications for both the diagnosis and surveillance of aortic aneurysms. The popular radiological features of an aortic aneurysm are aortic expansion, combined atherosclerosis, intraluminal mural thrombus, perianeurysmal inflammation and fibrosis, and perianeurysmal hemorrhage due to rupture. As rupture is the most important complication of an aortic aneurysm, various signs of an impending rupture have been suggested. These include the following: a maximum aneurysmal diameter larger than the threshold value, a high expansion rate, periaortic sentinel hemorrhage, and a hyperattenuating crescent in the mural thrombus or aneurysmal wall. To acknowledge the impending rupture of an aortic aneurysm, careful depiction of the clues is indispensable. (Korean Circulation J 2007;37:337-347)

Role of endoscopic ultrasonography in the diagnosis of dysphagia aortica

“…Chest CT is useful radiological modality in diagnosis of dysphagia in some patients. CT is used for evaluating both the aortic wall morphology and extra-aortic structures as possible causes of dysphagia [7]. The finding of DA on chest radiography is an unfolded aortic arch below which lies a tortuous dilated aorta.…”

A Patient With Dysphagia due to an Aortic Aneurysm

“…The radiographic findings are often inconclusive because a dilated, tortuous thoracic aorta is frequently encountered in elderly patients with dysphagia. Although a CT scan is useful for evaluating not only the aortic lumen, but also the aortic wall, 9) occasionally this is of no value in assessing compression of the esophagus by the aorta. 2) False negative results are common for barium swallow studies.…”