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Abdominal aortic ultrasound
Last reviewed: 05.07.2025
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Indications for ultrasound of the abdominal aorta
- A pulsating formation in the abdominal cavity.
- Pain in the midline of the abdomen.
- Circulatory disorders in the lower extremities.
- Recent abdominal trauma.
- Suspected idiopathic aortitis (patient under 40 years of age with clinical manifestations of vascular lesions of the aorta and its branches).
Preparation
Patient preparation. The patient should not eat or drink for 8 hours before the examination. If fluid intake is necessary, only water can be given. If clinical symptoms are acute, the examination can be performed without preparation. Children, if clinical conditions allow, should not eat or drink for 3 hours before the examination.
Patient position. The patient can lie in a comfortable position on his back. A small pillow can be placed under the head, in case of pronounced tension of the anterior abdominal wall, the pillow can also be placed under the patient's knees.
Apply the gel along the midline of the abdomen approximately 15 cm down from the xiphoid process to the symphysis.
It is better to perform scanning while holding your breath; the patient can also breathe calmly until a pathological area requiring particularly careful examination is identified.
Selecting a sensor: Use a 3.5 MHz sensor for adults. Use a 5 MHz sensor for children and thin adults.
Adjusting the sensitivity of the device.
Begin the examination by placing the transducer in the midline of the upper abdomen below the xiphoid process. Rotate the transducer to the right until the liver is imaged; adjust the sensitivity for optimal imaging.
Scanning technique
Return the transducer to the midline and move it slowly to the left until a tubular pulsating structure is visualized. Move along it to a level just below the navel, where a division of the aorta is identified: this is the aortic bifurcation.
Use transverse scanning to measure the aortic diameter at different levels. Visualization of the iliac arteries can be achieved by tilting the transducer slightly to the right or left below the aortic bifurcation.
If irregularities in the contour or other pathology are detected, make transverse sections also above and below the site of the detected pathology. In elderly patients, the course of the aorta may be altered, some displacement of the aorta or change in direction may be determined, but the diameter of the aorta should not change significantly. If the aorta is not visualized through the anterior abdominal wall, conduct the examination translumbarly in the direction of the left kidney.
Gas
When gas shielding the bowel, apply gentle pressure to the transducer and change the scanning angle; use oblique or lateral views if necessary and views on either side of the spine. Sometimes it is necessary to perform the examination with the patient standing to displace the gas-filled bowel.
When scanning the aorta, it is necessary to visualize the celiac trunk and the superior mesenteric artery.