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Abdominal aortic aneurysm morphology: CT features in patients with ruptured and nonruptured aneurysms.

Publication ,  Journal Article
Siegel, CL; Cohan, RH; Korobkin, M; Alpern, MB; Courneya, DL; Leder, RA
Published in: AJR Am J Roentgenol
November 1994

OBJECTIVE: We evaluated a variety of internal architectural features in ruptured and nonruptured abdominal aortic aneurysms to determine whether any features are associated more frequently with ruptured abdominal aortic aneurysms. These features may be useful in identifying subtle ruptures when no obvious retroperitoneal hematoma is present and may be helpful in predicting unstable aneurysms at risk for rupture. MATERIALS AND METHODS: The CT scans of 52 patients with ruptured abdominal aortic aneurysms were reviewed and compared with those of 56 patients with asymptomatic nonruptured aneurysms exceeding 4.5 cm in diameter. All aneurysms were evaluated for size, rim calcification, thrombus amount, thrombus calcification, and lumen irregularity. In addition, four different thrombus patterns were identified and evaluated, including homogeneous, diffusely heterogeneous, periluminal halo, and crescent patterns. Statistical comparisons were adjusted for differences in size between the two groups. RESULTS: Age, gender, and aneurysm length were not statistically different between the two groups. A larger diameter was found in the ruptured aneurysm group: 7.4 (anteroposterior) x 7.9 (transverse) cm versus 5.9 x 6.1 cm (p = .00001). More thrombus surrounded the nonruptured aneurysms (p = .014). Thrombus calcification was seen in 25% (14/56) of the control group and in 13% (7/52) of the rupture group (p = .01). Two thrombus patterns, homogeneous and periluminal halo, were encountered with similar frequencies in both groups. The diffusely heterogeneous pattern was seen more in the control group. A crescent of increased attenuation was encountered only in patients with ruptured aneurysms, at an incidence of 21% (11/52) (p = .0005). Thick and thin wall calcifications were seen in both groups, but a focal discontinuity in circumferential calcification was seen only in association with ruptured aneurysms, at an incidence of 8% (4/52) (p = .008). There was no significant difference in the number of patients whose patent lumen was irregular. CONCLUSION: In our series, detection of a high-attenuation crescent or focal gap of otherwise circumferential wall calcification is associated with aneurysm rupture. The homogeneous, diffusely heterogeneous, and periluminal halo patterns are not specifically associated with aortic rupture. There were no significant differences in the amount of wall calcification or frequency of lumenal irregularity between patients with ruptured and those with nonruptured aneurysms.

Duke Scholars

Published In

AJR Am J Roentgenol

DOI

ISSN

0361-803X

Publication Date

November 1994

Volume

163

Issue

5

Start / End Page

1123 / 1129

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Thrombosis
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Humans
  • Female
  • Endothelium, Vascular
  • Calcinosis
  • Aortic Rupture
 

Citation

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Siegel, C. L., Cohan, R. H., Korobkin, M., Alpern, M. B., Courneya, D. L., & Leder, R. A. (1994). Abdominal aortic aneurysm morphology: CT features in patients with ruptured and nonruptured aneurysms. AJR Am J Roentgenol, 163(5), 1123–1129. https://doi.org/10.2214/ajr.163.5.7976888
Siegel, C. L., R. H. Cohan, M. Korobkin, M. B. Alpern, D. L. Courneya, and R. A. Leder. “Abdominal aortic aneurysm morphology: CT features in patients with ruptured and nonruptured aneurysms.AJR Am J Roentgenol 163, no. 5 (November 1994): 1123–29. https://doi.org/10.2214/ajr.163.5.7976888.
Siegel CL, Cohan RH, Korobkin M, Alpern MB, Courneya DL, Leder RA. Abdominal aortic aneurysm morphology: CT features in patients with ruptured and nonruptured aneurysms. AJR Am J Roentgenol. 1994 Nov;163(5):1123–9.
Siegel, C. L., et al. “Abdominal aortic aneurysm morphology: CT features in patients with ruptured and nonruptured aneurysms.AJR Am J Roentgenol, vol. 163, no. 5, Nov. 1994, pp. 1123–29. Pubmed, doi:10.2214/ajr.163.5.7976888.
Siegel CL, Cohan RH, Korobkin M, Alpern MB, Courneya DL, Leder RA. Abdominal aortic aneurysm morphology: CT features in patients with ruptured and nonruptured aneurysms. AJR Am J Roentgenol. 1994 Nov;163(5):1123–1129.

Published In

AJR Am J Roentgenol

DOI

ISSN

0361-803X

Publication Date

November 1994

Volume

163

Issue

5

Start / End Page

1123 / 1129

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Thrombosis
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Humans
  • Female
  • Endothelium, Vascular
  • Calcinosis
  • Aortic Rupture