A contemporary review of non-invasive methods in diagnosing abdominal aortic aneurysms

Abstract

Background: Currently, the impact of abdominal aortic aneurysm may be changing despite the aging population, but may be ambiguous given the decline in smoking, the use of screening methods, and integration of non-surgical treatment. Objective: This review aimed to assess the most common currently used non-invasive methods to identify abdominal aortic aneurysm, namely ultrasound and computed tomography. Methods: PRISMA guidelines were utilized to retrieve original articles from the past five years. All retrospective and prospective studies/trials were included, but limited to US and CT abdominal aortic aneurysm diagnostic imaging methods. Qualitative assessment of study quality is described. Results: Three of the six studies reported abdominal aortic aneurysm screening data. The estimated prevalence of abdominal aortic aneurysm for the three studies ranged from 4.5% to 6.2%. CT had slightly higher sensitivity and US had higher specificity for abdominal aortic aneurysm diagnosis. Two of the described studies assessed technical issues and problems with contemporary imaging of abdominal aortic aneurysm. The final article described measuring abdominal aortic aneurysm function of aortic distensibility and its pulse wave velocity for a comprehensive assessment of the abdominal aortic aneurysm via standard CT imaging. Conclusions: Both US and CT are useful diagnostic imaging modalities for abdominal aortic aneurysm, but remain with unique pitfalls and propensity for errors, notwithstanding patient-related errors. Technical issues in imaging with both ultrasound and CT are not straightforward. The potential value of an integrated CT protocol with CT-US fusion and/or assessment of aortic function rather than solely aortic anatomy may further diminish diagnostic complexities.

Imaging options for patients with abdominal aortic aneurysms

“…SVS and USPSTF recommend diagnostic ultrasonography for screening for asymptomatic AAA given its accuracy and safety profile 1,8. Diagnostic abdominal ultrasonography has a sensitivity of 94% to 100% and a specificity of almost 100% for AAA 9. SVS and USPSTF guidelines recommend screening for AAA in men ages 65 to 75 years who have ever smoked 1,8.…”

“…1,8 Diagnostic abdominal ultrasonography has a sensitivity of 94% to 100% and a specificity of almost 100% for AAA. 9 SVS and uspstf guidelines recommend screening for AAA in men ages 65 to 75 years who have ever smoked. 1,8 SVS guidelines also recommend screening women ages 65 to 75 years who have ever smoked, patients ages 65 to 75 years who have a first-degree relative with an AAA, and patients age 75 years and older who are in good health but have never received a screening ultrasound for AAA.…”

“…JAAPA TABLE 1. Comparisons of imaging modalities for diagnosing AAAs 1,8,9,11,[12][13][14]17,20 Imaging modality…”