Ultrasound images of Aortic aneurysm

The most frequent referral for aortic scanning is to establish or monitor the presence of an aneurysm. The incidence of aortic aneurysm increases with For this reason, aortic aneurysms are monitored, and a graft placed within the vessel in aneurysms over 5 cm which are increasing in size. Postoperative complications of grafts, such as infection or pseudoaneurysm, are usually monitored with CT or MRI. Discussions of the benefits of screening programmes for selected populations are ongoing. However, there is some evidence that, despite the reduction of mortality due to aneurysm rupture, overall mortality in men over 65 remains unaffected by screening, and it has not been widely adopted into patient management. Most aneurysms are associated with atherosclerosis, which weakens the media of the wall, causing the vessel to dilate and eventually rupture. The aneurysm may be fusiform or saccular (Fig.8.3). Blood flow within it is turbulent, and the slow-flowing blood at the edges of the vessel tends to thrombose.
Surgery is always complicated by the involvement of the renal arteries. Fortunately, the vast majority of aneurysms are infrarenal, but it can be difficult to determine the relationship of the aneurysm to the renal artery origins on ultrasound, and CT is helpful in such cases. The use of angiography can be beneficial in this respect; however its disadvantage is that, unlike ultrasound, it displays only the lumen of the vessel and can underestimate the pathology present.

fig A

fig. B

Fig. C

ULTRASOUND IMAGES (A) LS demonstrating an aneurysm of the lower abdominal aorta. (B) TS through the aneurysm containing thrombus with an eccentric lumen demonstrating turbulent flow. (C) LS demonstrating flow around the thrombus in the aneurysm,