2. Abdominal Aortic Aneurysm
Presented By: Dr. Syed Shoaib Muhammad
Subject:
Applied Doppler, Vascular Doppler.

3.  Topic
 Anatomy Of The Abdominal Aorta
 Aneurysm Definition & Types.
 Probe Selection
 Patient Preparation
 Method
 Measurments.
Abdominal Aortic Aneurysm

4. ANATOMY OF THE ABDOMINAL AORTA

5. Normal Blood Vessel Wall.
 Vessel walls are organized into
three concentric layers: intima,
media, and adventitia.
 These are present to some extent
in all vessels but are most
apparent in larger arteries and
veins.

6. Aneurysm Definition.
 An abnormal blood-filled dilatation of a blood vessel and especially an
artery resulting from disease of the vessel wall.
Aneurysm Types.
 Saccular
 Fusiform
 Dissecting

7. Saccular
 Saccular aneurysm a distended
sac affecting only part of the
arterial circumference.

8. Fusiform
A localized dilation of an artery in
which the entire circumference
of the vessel is distended. The
result is an elongated, tubular, or
spindle like swelling.

9. Dissecting:
 one resulting from hemorrhage
that causes lengthwise splitting
of the arterial wall, producing a
tear in the inner wall (intima) and
establishing communication with
the lumen of the vessel.

10. Probe:
 Use The 3--5 MHz Transducer For The Abdominal Aorta Color Doppler.

11. Patient Preparation
No special preparation is required,
although some units use bowel
preparation to improve visualization
of the aorta; however, for screening
scans this is rarely necessary. The
patient should lie supine with the
head supported on a pillow.
Patient should be fasting 12-14 hour.
Before the scan patient must be
relaxed 20-30 mint.

12. Method:
1. Transverse image of the mid-aorta and IVC.
Line of Liver
4
1
5
2
3

13. Method:
2. Sagittal image of the aorta.
Line of Liver
4
1
5
2
3

14. Method:
3. Coronal imaging plane.
Line of Liver
4
1
5
2
3

15. Method:
4. Imaging through the liver to identify the proximal aorta and IVC.
Line of Liver
4
1
5
2
3

16. Method:
5. Imaging the aortic bifurcation in longitudinal plane from a right oblique
position enables both common iliac arteries to be seen in the same image.
Line of Liver
4
1
5
2
3

17. Before Meal After Meal
PSV EDV PI PSV EDV PI
Superior
Mesenteric
Artery
100 16 3.6 120 30 1.5
Celiac
Artery
125 23 1.8 130 40 1.5
Measurements:

18. Superior Mesenteric A. Celiac Axis
Normal 125 ± 25 123 ± 27
Atherosclerosis 163 ± 59 138 ± 38
Stenosis (70-99%) PSV ≥ 275 PSV ≥ 200
Velocity (Mean ± SD cm/s)

19. Inferior Mesenteric Artery Measurements:
PSV 0.98 ± 0.30 m/s or (98.0 ± 30.0 cm/s)
EDV 0.11 ± 0.05 m/s or (11.0 ± 5.0 cm/s)
Mean Velocity 0.25 ± 0.08 m/s or (25.0 ± 8.0 cm/s)
R.I (SD) 0.89 ± 0.06 m/s or (89.0 ± 6.0 cm/s)
P.I 4.50 ± 1.53 m/s or (450 ± 153 cm/s)
Pulsatility Index
PI = S – D
Mean
Resistive Index
RI = S – D
D

20. Criteria For Mesenteric Artery Stenosis.
Celiac Artery
PSV ≥ 200 cm/s = ≥ 70 % stenosis
Flow is Absent. = Occluded
EDV ≥ 55 cm/s = ≥ 50 % stenosis
Superior Mesenteric
Artery
PSV ≥ 275 cm/s = ≥ 70 % stenosis
Flow is Absent. = Occluded
EDV ≥ 45 cm/s = ≥ 50 % stenosis
Common Hepatic Artery Retrograde Flow
= severe celiac artery
stenosis or occlusion

21.  Paul L. Allen (3rd Edition)
 http://medical-dictionary.thefreedictionary.com/saccular+aneurysm
 http://www.nlm.nih.gov/medlineplus/mplusdictionary.html
 http://dictionary.reference.com/browse/saccular+aneurysm?s=t
 http://www.ultrasound-images.com