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Abdominal Aortic Aneurysm Imaging - Radiography

Ngày 01/08/2016 03:52 | Lượt xem: 2894

Radiography

Calcification of the abdominal aortic wall is frequently evident on plain radiographs of the abdomen, as demonstrated in the images below. 

Calcification is best seen on lateral views when the spine does not obscure the opposing walls of the vessel. When calcification can be clearly identified in the opposing aortic walls, abdominal aortic aneurysms (AAAs) can be diagnosed with the plain radiographic findings.

Radiograph shows calcification of the abdominal aorta. The left wall is clearly depicted and appears aneurysmal; however, the right wall overlies the spine. Because both walls must be calcified for a diagnosis of abdominal aortic aneurysm, lack of a clear view of the right wall makes diagnosis uncertain.

The lateral view clearly shows calcification of both walls. Abdominal aortic aneurysm can be diagnosed with certainty.

Degree of confidence

If the classic eggshell appearance is present, the degree of confidence is approximately 100%; however, this finding is present only in 50% of patients. Occasionally, only the anteroposterior or lateral abdominal image demonstrates the findings clearly. If AAAs are suspected, perform abdominal US or CT for confirmation. As such, negative plain radiographic findings do not exclude the diagnosis in any way.

False positives/negatives

A tortuous, calcified aorta can mimic AAA unless both walls can be seen clearly. If the opposing walls are not calcified, the diagnosis cannot be made with certainty. In these cases, US, CT, or MRI must be performed if AAA is clinically suspected

Source emedicine.com

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