Abdominal Vasculature - Part 5 Flashcards
What are the indications for an abdominal aorta US? (10)
- Pulsatile abdominal mass
- Family history of abdominal aortic aneurysm
- Hypertension
- Abdominal pain
- Lower back pain
- History of arteriosclerosis
- Severe postprandial pain
- Pulmonary embolism
- Liver disease
- Evaluate mass from previous medical imaging study
- eg) CT
Aneurysm
Weakening of the arterial wall
What happens to the vessel walls with an aneurysm?
All layers of the artery are stretched but intact
When are aneurysms more rare?
In patients less than 50 years
Are aneurysms more common in males or females?
Males
What is considered a normal growth rate for an aneurysm?
Growth rate of 2mm/year is average and considered normal up to 5mm/year
What size is the aorta when there is an aneurysm?
When is exceeds 3.0cm in diameter
What size is the common iliac artery when there is an aneurysm?
When is exceeds 2.0cm in diameter
What size is the popliteal artery when there is an aneurysm?
When is exceeds 1.0cm in diameter
What is 25% of popliteal aneurysms associated with?
Abdominal aortic
aneurysm
Arterial stenosis
Narrowing or constriction of an artery
What is an arterial stenosis caused by? (3)
- Atherosclerosis
- Arteriosclerosis
- Fibrointimal hyperplasia
Arteriosclerosis
Pathologic thickening, hardening, and loss of elasticity of the arterial walls
Atherosclerosis
Disorder characterized by yellowish plaques of lipids and cellular debris in the medial and intimal layers of the arterial walls
Pseudoaneurysm
Dilatation of an artery caused by damage to one or more layers of the artery as a result of trauma or aneurysm rupture
What is the most common cause and an abdominal aortic aneurysm?
Arteriosclerosis
What are other causes of an abdominal aortic aneurysm? (3)
- Infection
- Hypertension
- Family history
What are the clinical findings of an abdominal aortic aneurysm? (5)
- Asymptomatic
- Pulsatile abdominalmass
- Back and/or leg pain
- Abdominal pain
- Abdominal bruit
What is the US appearance of an abdominal aortic aneurysm? (6)
- Typically fusiform-shaped dilatation of the aorta
- Saccular dilatation of the aorta may be demonstrated
- Diameter of 3cm or greater
- Vessel becomes tortuous 5. Wall calcifications
- Intramural thrombus
What are 3 differential diagnosis of an abdominal aortic aneurysm?
- Lymphadenopathy 2. Retroperitoneal tumour
3. Dissection
What are the causes of a dissecting aneurysm? (5)
- Extension of a dissecting thoracic aneurysm
- Hypertension
- Marfan syndrome
- Idiopathic
- Trauma
What are the clinical findings of a dissecting aneurysm? (4)
- Sharp chest or abdominal pain
- Audible bruit
- Headache
- Shock
What is the US appearance of a dissecting aneurysm? (3)
- Thin hyper echoic membrane within the aorta
- Membrane flaps with arterial pulsations
- Doppler demonstrates opposite flow direction between the membrane during diastole
What are 2 differential diagnosis for dissecting aneurysm?
- Chronic intraluminal thrombus
2. Postsurgical repair
What causes an ectatic aneurysm?
Weakening of the arterial wall
What is a clinical find of an ectatic aneurysm?
Asymptomatic
What is the US appearance of an ectatic aneurysm? (2)
- Dilatation of the aorta when compared with a more proximal segment
- Dilatation measures less than 3cm in diameter
What are 2 differential diagnosis of an ectatic aneurysm?
- Tortuous artery
2. Technical error
What is a cause of mycotic aneurysm?
Bacterial infection
What are clinical findings of mycotic aneurysm? (3)
- Asymptomatic
2. Abdominal pain 3. Pulsatile abdominal mass
What is the US appearance of mycotic aneurysm? (2)
- Typically saccular-shaped dilatation of the aorta
2. Asymmetrical wall thickening
What are 3 differential diagnosis of mycotic aneurysm?
- Lymphadenopathy 2. Retroperitoneal tumour
3. Intramural thrombus
What is a cause of a pseudoaneurysm?
Trauma to the arterial wall permits the escape of blood into the surrounding tissues
What is the most common complication of an aortic graft?
Pseudoaneurysm
What are clinical findings of a pseudoaneurysm? (3)
- Pulsatile mass
- Focal pain
- Bruising
What is the US appearance for a pseudoaneurysm? (3)
- Fluid collection communicating with an artery
- Doppler will demonstrate
turbulent swirling blood flow within the fluid collection - To and fro blood flow pattern is demonstrated in the neck of the aneurysm
What are 4 differential diagnosis for a pseudoaneurysm?
- Hematoma
- Lymphadenopathy
- Aneurysm
- Arteriovenous fistula
