What Is the Ideal Imaging Strategy for Diagnosing AAA, Abdominal Aortic Dissection, and Aortic Rupture?
The best imaging modality for diagnosis and preoperative management of abdominal aortic pathology is computed tomography angiography (CTA) due to its ability to quickly and accurately map the aneurysm or dissection, identifying location, size, and other involved arterial branches. Ultrasound is the imaging modality of choice for rapid bedside diagnosis of abdominal aortic aneurysm in the emergency setting. It is also used for surveillance of known aneurysmal disease. Diagnostic studies should not delay operative management in patients with strong clinical suspicion for aortic rupture, especially if the patient is hemodynamically unstable and has a previous diagnosis of aortic aneurysm and/or dissection.
KeywordsAortic dissection Abdominal aortic aneurysm Aortic rupture Computed tomography Ultrasound Magnetic resonance imaging Radiography Angiography
- 1.Reardon RF, Clinton ME, Madore F, Cook TP. Abdominal aortic aneurysm. In: Ma OJ, Mateer JR, Reardon RF, Joing SA, editors. Ma & Mateer’s emergency ultrasound. 3rd ed. New York (NY): McGraw Hill; 2014. p. 225–45.Google Scholar
- 7.Hiratzka LF, Bakris GL, Beckman JA, Bersin RM, Carr VF, Casey J, Donald E, et al. Practice guideline: full text: 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with thoracic aortic disease. J Am Coll Cardiol. 2010;55:e27–e129.CrossRefGoogle Scholar
- 11.Guirguis-Blake J, Beil TL, Sun X, Senger CA, Whitlock EP. Primary care screening for abdominal aortic aneurysm: a systematic evidence review for the U.S. Preventive Services Task Force. Jan 2014.Google Scholar
- 15.Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, et al. ACC/AHA practice guideline: ACC/AHA 2005 guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): executive summary a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, AAVS/SVS when guideline initiated, now merged into SVSSociety 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). Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. J Am Coll Cardiol. 2006;47:1239–312.CrossRefGoogle Scholar
- 16.Thrumurthy SG, Karthikesalingam A, Patterson BO, Holt PJE, Thompson MM. The diagnosis and management of aortic dissection. BMJ (Overseas & Retired Doctors Edition). 2012;344(7839):37–42.Google Scholar