Ultrasound Pictures of Dissecting Aortic Aneurysm

Clinical manifestations Dissecting Aortic Aneurysm: Severe pain of sudden onset, similar to that of renal colic (migrates as the dissection advances along the aorta). Dyspnea and syncope are also present. Neurologic deficits may occur, depending on the site of the dissection. Multiple episodes are common. Initially the dissection is confined to the intima, and the dissecting blood creates a false lumen. Later the aneurysm may rupture, causing death. Hemorrhagic shock may occur, depending on the extent of the dissection.

Occurrence Dissecting Aortic Aneurysm: Most common in elderly patients with significant atherosclerosis.
Many patients have a prior history of hypertension.

Diagnosis Dissecting Aortic Aneurysm: It is essential not to overlook the diagnosis of a dissecting aortic aneurysm.

x History: Laboratory tests with Hb monitoring x Sonography, particularly color duplex; transesophageal sonography is recommended for thoracic scanning
x CT, MRI

Sonographic findings Dissecting Aortic Aneurysm:
x Aortic dilatation i 25mm; massive aortic enlargement not always present.
x Echogenic plaques are usually seen as an expression of atheromatosis; they
may be hard (with acoustic shadowing) or soft (no shadowing).
x Echogenic band floating in the aortic lumen (intimal flap).
x Double aortic lumen; the second lumen may be echogenic, indicating thrombotic occlusion.
x CDS: Can differentiate the false lumen from the true lumen (by detecting different flow velocities).

Accuracy of sonographic diagnosis Dissecting Aortic Aneurysm: With adequate visualization, sonography can confirm the diagnosis in 98% of cases. A CT scan is often done preoperatively.

a, b Dissecting aneurysm of the abdominal aorta. The aorta (A) is markedly expanded, and partial thrombosis (TH) is seen at the periphery of its lumen. Arrows: echogenic intimal flap with anechoic false lumen .

“Ultrasound Upper Abdominal Pain Dissecting Aortic Aneurysm”

“ ULTRASOUND PICTURES OF Dissecting Aortic Aneurysm”