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Have Ultrasound Performed. Showed Enlargement In Repaired Aneurisym. What Can This Be?
Question: in nov. 2004,i had a AAA .each year in nov.,I have an ultrasound performed.each yr. it has stayed normal and stable.this year,because they spotted a slight kinking in the renal artery,so a follow up ultra sound was performed in 3 mo.in that short period of time there was an enlargement in my repaired aneurisym.my question is how accurate is the ultra sound
Hello XXXXX,
Thanks for writing in.
This is Dr Vivek answering your question.
From given medical history, you are a 74 years old gentleman diagnosed with an Abdominal Aortic Aneurysm in November 2004. It has been a relatively stable till this year when there was an enlargement with slight kinking of renal artery. Now your question is based on accuracy of ultrasound for AAA.
You have an important question which is asked by very few patients. I have reviewed medical literature based on your question. There has been a lot of clinical research on the topic and I would be happy to explain the facts to you in simple language.
It would have been great if you shared information on when your aneurysm was repaired. Anyways please do not worry as the facts presented here are from original studies conducted on patients.
Following endovascular repair of AAA, long-term and perhaps lifelong imaging surveillance is essential to predict any problems in future.
It has been said that in about 33% patients CT scan angiography measurements of abdominal aortic aneurysms may exceed the ultrasound measurement by about 5 mm. Which means the ultrasound measurement of aneurysm diameter may be smaller than as seen on CT scan.
We must remember that no single test is 100% accurate. However the number of endoleaks identified on CT and missed on duplex scans exceeded the number of those identified on duplex scans and missed on CT. This aspect was however not worrisome as in those patients where there was any discrepancy, it was not a serious life threatening condition.
Thus, reliance on duplex scan alone would not have resulted in different clinical management and treatment.
In conclusion, high-quality duplex ultrasound scanning is comparable to CT angiography for measuring aneurysm size and for identifying endoleaks after endovascular exclusion of AAA. It may be used for surveillance and routine follow-up.
So there is no significant difference between an abdominal aortic aneurysm enlargement picked up by ultrasound from that as visible on CT scan.
Note: The above conclusion has been drawn from multiple research studies done at many hospitals.
I would be delighted to answer more questions that you may have.
Thanks to you once again for asking such an important question for both, doctors and patients.
Wishing you good health.
Regards
Dr Vivek
Thanks for writing in.
This is Dr Vivek answering your question.
From given medical history, you are a 74 years old gentleman diagnosed with an Abdominal Aortic Aneurysm in November 2004. It has been a relatively stable till this year when there was an enlargement with slight kinking of renal artery. Now your question is based on accuracy of ultrasound for AAA.
You have an important question which is asked by very few patients. I have reviewed medical literature based on your question. There has been a lot of clinical research on the topic and I would be happy to explain the facts to you in simple language.
It would have been great if you shared information on when your aneurysm was repaired. Anyways please do not worry as the facts presented here are from original studies conducted on patients.
Following endovascular repair of AAA, long-term and perhaps lifelong imaging surveillance is essential to predict any problems in future.
It has been said that in about 33% patients CT scan angiography measurements of abdominal aortic aneurysms may exceed the ultrasound measurement by about 5 mm. Which means the ultrasound measurement of aneurysm diameter may be smaller than as seen on CT scan.
We must remember that no single test is 100% accurate. However the number of endoleaks identified on CT and missed on duplex scans exceeded the number of those identified on duplex scans and missed on CT. This aspect was however not worrisome as in those patients where there was any discrepancy, it was not a serious life threatening condition.
Thus, reliance on duplex scan alone would not have resulted in different clinical management and treatment.
In conclusion, high-quality duplex ultrasound scanning is comparable to CT angiography for measuring aneurysm size and for identifying endoleaks after endovascular exclusion of AAA. It may be used for surveillance and routine follow-up.
So there is no significant difference between an abdominal aortic aneurysm enlargement picked up by ultrasound from that as visible on CT scan.
Note: The above conclusion has been drawn from multiple research studies done at many hospitals.
I would be delighted to answer more questions that you may have.
Thanks to you once again for asking such an important question for both, doctors and patients.
Wishing you good health.
Regards
Dr Vivek
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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