Ultrasound diagnostics of the abdominal aorta

Abstract

Background and objectivesThe ideal method for screening investigations is one which is as free as possible from side effects, is easily learnt, and can therefore be broadly used to detect abdominal aortic aneurysms (AAA) with a high degree of certainty. Although ultrasonography fulfils these criteria, the measurement method is not standardized. Different measurement methods are used in ultrasonography as well as in computed tomography (CT) studies and the measurement method is actually described sufficiently in only 57 % of cases.MethodsThis article provides a critical review of the current literature on measurement methods and the validity of ultrasonography for the determination of aortic diameter, particularly in AAA, and presents the measurement principles for making measurements as precisely as possible.Results and conclusionThe most precise determination of aortic diameter is carried out by electrocardiogram (ECG) gating according to the leading-edge method with orthogonal slicing. Within the framework of screening investigations, sufficient measurement precision can be achieved by adherence to orthogonal slicing. Using these standardized measurement methods, ultrasonography shows valid and reproducible results even compared with CT and is the method of choice in screening investigations for AAA. Electronic Supplementary Material is available for this article at 10.1007/s00772-014-1411-1 and accessible for authorised users.

Epidemiology, Clinical Features, and Prescribing Patterns of Aortic Aneurysm in Asian Population From 2005 to 2011

“…We identified patients who were diagnosed as having aortic aneurysm (International Classification of Diseases, ninth revision, Clinical Modification [ICD-9-CM]: 441.1–441.7, 441.9) between January 1, 2004 and December 31, 2012. Since computed tomography (CT) was generally considered the criterion standard for diagnosis of AA, 18 we excluded patients without CT scan within 1 year after index date. The index date was assigned as the first date of AA diagnosis.…”

Overview of common errors and pitfalls to avoid in the acquisition and interpretation of ultrasound imaging of the abdominal aorta

“…The patient may need to be placed in the lateral decubitus position with concomitant gentle pressure on the abdomen to displace bowel to the side. 26,35,36 Increased body mass index is an obstacle for optimal ultrasound image acquisition. Increased waist circumference and variability in ultrasound measurements of the abdominal aorta have been reported.…”

“…Occasionally, the frequency will need to be decreased further in order to improve penetration. 35 The presence of a ruptured AAA may make the tubular structure of the aorta wall difficult to identify. 8,38 Ultrasonography has limitations in the detection of a ruptured AAA, since retroperitoneal fluid is poorly visualized with abdominal sonography.…”

Aneurysmen der infrarenalen Aorta: Klinik, Diagnostik einschließlich Screening und Therapieindikationen

“…Im schwedischen AAA-Screening-Programm wird dagegen der maximale Querdurchmesser im Längsbild nach der sog. Leading-edge-Methode erfasst (maximaler anterior-posteriorer Querdurchmesser) (Schäberle et al 2014).…”