Ultrasound diagnostics of the abdominal aorta: English version.

W Schäberle,W Schierling,K Pfister,L Leyerer

doi:10.1007/s00772-014-1411-1

W Schäberle, W Schierling + Show 2 more

Open Access

https://doi.org/10.1007/s00772-014-1411-1

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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.

Highlights

Ultrasonography of the aorta is primarily performed to detect or exclude an abdominal aortic aneurysm (AAA)
These particular aspects of the LELE method cause relevant yet not serious measurement inaccuracies and are less relevant in primary aortic screening. They are relevant when making the indication for surgery in borderlinesized AAA and monitoring
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 computed tomography (CT) and is the method of choice in screening investigations for AAA

Summary

Introduction

Ultrasonography of the aorta is primarily performed to detect or exclude an abdominal aortic aneurysm (AAA). Color duplex ultrasound is only required to distinguish the perfused lumen from wall thrombus and in the differential diagnosis of rare findings, such as inflammatory aortic aneurysm and aortitis (giant cell arteritis) This method makes is easier to establish the topographical relationship of an aneurysm to the renal arteries, as well as its relationship to the internal iliac artery branch in the case of significant longitudinal extension of the aneurysm. These particular aspects of the LELE method cause relevant yet not serious measurement inaccuracies (an overall maximum of 5–6 mm) and are less relevant in primary aortic screening They are relevant when making the indication for surgery in borderlinesized AAA and monitoring (surgery is indicated if aneurysm diameter increases by 5 mm within 6 months).

Results and conclusion

Conclusion

Compliance with ethical guidelines