Advertisement

Screening for abdominal aortic aneurysms during routine lumbar CT scan

Modification of the standard technique

      Abstract

      Introduction

      Abdominal aortic aneurysms (AAAs) are often incidental findings in patients undergoing US, CT or MRI studies. The recommended field of view (FOV) for standard CT examinations of the spine is 14 cm. This FOV does not allow full visualization of the abdominal aorta.

      Purpose

      To justify a larger FOV for male smokers older than 55 years and women older than 65 years, with a higher incidence of AAA.

      Materials and methods

      The lumbar CT examinations of 100 consecutive patients (age: mean 68 years, range 55–85 years) presented with low-back pain were retrospectively reviewed. Measurements of the abdominal aorta and lumbar abnormalities were analysed. A control study in 850 patients who underwent abdominal CT scans for other causes was available for comparison.

      Results

      There were three men with AAAs measuring 4.5, 5.5 and 5.6 cm (mean 5.2 cm). Findings related to the clinical problem were disk prolapse or herniation, spondylosis, spinal stenosis and grade I spondylolesthesis. In the control group, 17 patients were found with AAAs with diameter greater than 4 cm (2%).

      Conclusions

      Patients with low-back pain, older than 55 years of age, examined with lumbar spine CT, should also be screened for aortic disease, since the prevalence of AAA is similar with that of an age-matched control group. Appropriate modification in the applied FOV is recommended.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Clinical Imaging
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Marsman JW
        Risk of small field of view in lumbar spine computed tomography for assumed lumbar disc herniation: beware contained ruptured aortic aneurysm.
        Australas Radiol. 1995; 39: 153-158
        • Lederle AF
        • Johnson GR
        • Wilson SE
        • Chute EP
        • Littooy FN
        • Bandy KD
        • Krupski WC
        • Barone GW
        • Acher CW
        • Ballard DJ
        Prevalence and associations of AAA detected through screening.
        Am Intern Med. 1997; 126: 441-449
        • Pavone P
        • DiCesare E
        • DiRenzi P
        • Marsili L
        • Ventura M
        • Spartera C
        • Passariello R
        Abdominal aortic aneurysm evaluation: comparison of US, CT, MRI and angiography.
        Magn Reson Imaging. 1990; 8: 199-204
        • Karkos CD
        • Mukhopadhyay U
        • Papakostas I
        • Ghosh J
        • Thompson GJ
        • Hughes R
        Abdominal aortic aneurysm: the role of clinical examination and opportunistic detection.
        Eur J Vasc Endovasc Surg. 2000; 19: 200-303
        • Wilmink TB
        • Quick CR
        • Hubbard CS
        • Day NE
        The influence of screening on the incidence of ruptured abdominal aortic aneurysms.
        J Vasc Surg. 1999; 30: 203-208
        • Scott RA
        • Wilson NM
        • Ashton HA
        • Kay DN
        Influence of screening on the incidence of ruptured abdominal aortic aneurysm: 5-year results of a randomized controlled study.
        Br J Surg. 1995; 82: 1066-1070