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KEY FACTS
Terminology
Imaging
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
- Abdominal aortic aneurysm (AAA)
Definitions
- Abdominal aortic aneurysm
- Fusiform or saccular enlargement of aorta ≥ 1.5x normal diameter (> 3 cm in abdominal aorta)
- AAA is described by its relationship to renal arteries
- Infrarenal: > 1 cm of normal aorta below renal arteries
- Juxtarenal: Begins within 1 cm of renal arteries
- Suprarenal: Extends above renal arteries
- Inflammatory aneurysm: Uninfected AAA with enhancing circumferential inflammatory tissue
- 5% of AAA
- Abdominal pain may mimic rupture
- Adjacent structures (e.g., duodenum) involved
- 5% of AAA
- Mycotic aneurysm
- Misnomer because any infectious agent may be underlying cause
- Rare but associated with high mortality
- Primary = direct extension from adjacent infection
- Secondary = embolic (endocarditis)
- Cryptogenic = seeding during septicemia
- Salmonella, Staphylococcus aureus, Streptococci
- Endovascular aneurysm repair (EVAR): Placement of intravascular endograft to bridge aortoiliac segments and depressurize AAA
- Endoleak: Persistent flow of blood outside endograft
- Abdominal aortic aneurysm
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Angiographic Findings
Imaging Recommendations
Nuclear Medicine Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
- Jackson RS et al: Comparison of long-term survival after open vs endovascular repair of intact abdominal aortic aneurysm among Medicare beneficiaries. JAMA. 307(15):1621-8, 2012
- Sommer WH et al: Time-resolved CT Angiography for the Detection and Classification of Endoleaks. Radiology. 263(3):917-26, 2012
- Thawait SK et al: Group B streptococcus mycotic aneurysm of the abdominal aorta: report of a case and review of the literature. Yale J Biol Med. 85(1):97-104, 2012
- Walker TG et al: Image optimization during endovascular aneurysm repair. AJR Am J Roentgenol. 198(1):200-6, 2012
- Truijers M et al: Endovascular aneurysm repair: state-of-art imaging techniques for preoperative planning and surveillance. J Cardiovasc Surg (Torino). 50(4):423-38, 2009
- Lin MP et al: A comparison of computed tomography, magnetic resonance imaging, and digital subtraction angiography findings in the diagnosis of infected aortic aneurysm. J Comput Assist Tomogr. 32(4):616-20, 2008
- Blankensteijn JD et al: Two-year outcomes after conventional or endovascular repair of abdominal aortic aneurysms. N Engl J Med. 352(23):2398-405, 2005
- Eickhoff JH: Incidence of diagnosis, operation and death from abdominal aortic aneurysms in Danish hospitals: results from a nation-wide survey, 1977-1990. Eur J Surg. 159(11-12):619-23, 1993
- LaRoy LL et al: Imaging of abdominal aortic aneurysms. AJR Am J Roentgenol. 152(4):785-92, 1989
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
- Abdominal aortic aneurysm (AAA)
Definitions
- Abdominal aortic aneurysm
- Fusiform or saccular enlargement of aorta ≥ 1.5x normal diameter (> 3 cm in abdominal aorta)
- AAA is described by its relationship to renal arteries
- Infrarenal: > 1 cm of normal aorta below renal arteries
- Juxtarenal: Begins within 1 cm of renal arteries
- Suprarenal: Extends above renal arteries
- Inflammatory aneurysm: Uninfected AAA with enhancing circumferential inflammatory tissue
- 5% of AAA
- Abdominal pain may mimic rupture
- Adjacent structures (e.g., duodenum) involved
- 5% of AAA
- Mycotic aneurysm
- Misnomer because any infectious agent may be underlying cause
- Rare but associated with high mortality
- Primary = direct extension from adjacent infection
- Secondary = embolic (endocarditis)
- Cryptogenic = seeding during septicemia
- Salmonella, Staphylococcus aureus, Streptococci
- Endovascular aneurysm repair (EVAR): Placement of intravascular endograft to bridge aortoiliac segments and depressurize AAA
- Endoleak: Persistent flow of blood outside endograft
- Abdominal aortic aneurysm
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Angiographic Findings
Imaging Recommendations
Nuclear Medicine Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
- Jackson RS et al: Comparison of long-term survival after open vs endovascular repair of intact abdominal aortic aneurysm among Medicare beneficiaries. JAMA. 307(15):1621-8, 2012
- Sommer WH et al: Time-resolved CT Angiography for the Detection and Classification of Endoleaks. Radiology. 263(3):917-26, 2012
- Thawait SK et al: Group B streptococcus mycotic aneurysm of the abdominal aorta: report of a case and review of the literature. Yale J Biol Med. 85(1):97-104, 2012
- Walker TG et al: Image optimization during endovascular aneurysm repair. AJR Am J Roentgenol. 198(1):200-6, 2012
- Truijers M et al: Endovascular aneurysm repair: state-of-art imaging techniques for preoperative planning and surveillance. J Cardiovasc Surg (Torino). 50(4):423-38, 2009
- Lin MP et al: A comparison of computed tomography, magnetic resonance imaging, and digital subtraction angiography findings in the diagnosis of infected aortic aneurysm. J Comput Assist Tomogr. 32(4):616-20, 2008
- Blankensteijn JD et al: Two-year outcomes after conventional or endovascular repair of abdominal aortic aneurysms. N Engl J Med. 352(23):2398-405, 2005
- Eickhoff JH: Incidence of diagnosis, operation and death from abdominal aortic aneurysms in Danish hospitals: results from a nation-wide survey, 1977-1990. Eur J Surg. 159(11-12):619-23, 1993
- LaRoy LL et al: Imaging of abdominal aortic aneurysms. AJR Am J Roentgenol. 152(4):785-92, 1989
