Difference between revisions of "Aortic ultrasound"

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[[Category: Rads]]
 
[[Category: Rads]]
 
[[Category:Vascular]]
 
[[Category:Vascular]]
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[[Category:Ultrasound]]

Revision as of 15:28, 1 November 2015

Technique

  • Transverse
    • Start in epigastrium (below diaphragm) with indicator at 9 o'clock (aorta on left/IVC on right)
    • Use liver as window
    • Identify vertebral body (shadowing)
    • Rock/jiggle probe or hold steady pressure to move bowel gas from view
    • Scan from celiac to bifurcation (near umbilicus)
    • Capture and measure the largest diameter
  • Sagittal
    • Rotate indicator to 12 o'clock (aorta on top/vertebra on bottom of screen)
    • Ensure you're looking at aorta and not IVC (aorta may pulsate/IVC may be compressible)
    • Scan from bifurcation to celiac
    • Capture and measure sagittal views, including the largest diameter
  • Measurements
    • Normal is <3cm
    • Measure outer wall to outer wall (make sure to include thrombus)
    • Fusiform more common
      • Watch out for saccular aneurysms

Misc

  • Obese Patients
    • Can try posterior approach

Findings

  • Abdominal Aortic Aneurysm
    • >3cm diameter (transverse or saggital)
    • Look for free fluid
    • Try to reproduce pain with probe
    • If clot, confirm flow with doppler
    • Aorta may be lifted off spine 2/2 thrombus

AAA.png

Type B Dissection.png

Pitfalls

  • Preferred 9 to 3 o'clock measurements
    • Avoids posterior acoustic wall enhancement
    • Best wall to wall measurement
  • AAA vs Dissection
    • Scan above and below area of concern
      • Dissections will continue while AAA typically are located in single area
      • Dissections can be a normal diameter

See Also

Source

  • Sonosite