Fusiform Aneurysm

A 68-year-old asymptomatic male underwent abdominal aorta aneurysm (AAA) ultrasound screening. A dilated segment of the abdominal aorta was identified in the lower abdominal aorta. The maximum outer wall to outer wall diameter of the dilated segment was 7.3 cm. The patient was immediately referred to a vascular surgeon for further investigation and management. Next day, the patient had endovascular aneurysm repair (EVAR). What type of aneurysm was it based on the ultrasound image below? The image was obtained in the mid-longitudinal plane.    a. Berry aneurysm  b. Fusiform aneurysm  c. Cannot determine from the image  Explanation  The ultrasound image shows a mid-longitudinal view of the abdominal aorta through the aneurysmal segment. This is an example of a fusiform type of abdominal aortic aneurysm.  Figure 1. Types of abdominal aortic aneurysms. Saccular/berry aneurysm on the left and fusiform aneurysm on the right. Approximately 94% of aortic aneurysms are fusiform while 90% of cerebral aneurysms are saccular or berry aneurysms.  References  https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/abdominal-aortic-aneurysm-screening  https://www.pocus101.com/aorta-ultrasound-made-easy-step-by-step-guide/  https://sonographictendencies.com/2021/03/17/aorta-duplex-doppler-protocol/ 

A 68-year-old asymptomatic male underwent abdominal aorta aneurysm (AAA) ultrasound screening. A dilated segment of the abdominal aorta was identified in the lower abdominal aorta. The maximum outer wall to outer wall diameter of the dilated segment was 7.3 cm. The patient was immediately referred to a vascular surgeon for further investigation and management. Next day, the patient had endovascular aneurysm repair (EVAR). What type of aneurysm was it based on the ultrasound image below? The image was obtained in the mid-longitudinal plane. 

 

a. Berry aneurysm 

b. Fusiform aneurysm 

c. Cannot determine from the image 


Explanation 

The ultrasound image shows a mid-longitudinal view of the abdominal aorta through the aneurysmal segment. This is an example of a fusiform type of abdominal aortic aneurysm. 

Figure 1. Types of abdominal aortic aneurysms. Saccular/berry aneurysm on the left and fusiform aneurysm on the right. Approximately 94% of aortic aneurysms are fusiform while 90% of cerebral aneurysms are saccular or berry aneurysms. 

References 

https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/abdominal-aortic-aneurysm-screening 

https://www.pocus101.com/aorta-ultrasound-made-easy-step-by-step-guide/ 

https://sonographictendencies.com/2021/03/17/aorta-duplex-doppler-protocol/ 

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