Aortic ultrasound: Difference between revisions
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Revision as of 15:14, 18 October 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
- Aortic Dissection
- Double lumen separated by intimal flap
- Confirm with doppler
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
- Scan above and below area of concern
See Also
Source
- Sonosite