The draped aorta sign of impending aortic aneurysm rupture

Vertebral Erosion Secondary to Aortic Aneurysm

“…The thoracoabdominal CT angiography is the reference examination, and it allows studying the whole thoracoabdominal aorta and its branches and assessing the relationship with the different adjacent structures (vertebrae, psoas, and the peritoneal retro); it also makes it possible to objectify the signs of aneurysmal rupture (intra-or retroperitoneal hematoma) or predictive signs of rupture, such as rupture of the continuity of parietal calcifications and the sign of the crescent or the sign of the draped aorta [6]; the latter is of great diagnostic value, and it is considered positive when the posterior wall of an aortic aneurysm is draped or molded on the anterior surface of the vertebra, with loss of the fat planes located between the aneurysm and the vertebra. Its presence indicates a weakening of the aortic wall and an imminent risk of rupture [5,6].…”

Vertebral body erosion secondary to aortoiliac aneurysm

“…The mechanism suggested in this context is repetitive mechanical pressure by arterial pulsation, which would cause chronic ischemia in the bone matrix, leading to bone lysis and remodeling. ( 2 – 5 ) Preservation of the disk spaces decreases the risk of infection and helps in making differential diagnosis. This finding indicates an imminent risk of rupture, which must be promptly identified.…”

“…Therefore, radiologists should be familiarized with such images indicating an impeding risk of rupture of abdominal aorta aneurysm, even in non-contrast enhancement exams. ( 5 , 6 )…”