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Ultrasound of the abdominal aorta
Last reviewed: 20.11.2021
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Indications for ultrasound of the abdominal aorta
- Pulsating formation in the abdominal cavity.
- Pain along the midline of the abdomen.
- Violation of blood circulation in the lower limbs.
- Recently suffered abdominal trauma.
- Suspicion of idiopathic aortitis (a patient under 40 years of age with a clinic of vascular lesions of the aorta and its branches).
Preparation
Preparation of the patient. The patient should not eat or drink for 8 hours before the test. If you need a liquid, you can only give water. If the clinical symptomatology is acute, then the study can be conducted without preparation. Children, if the clinical conditions permit, should not eat and drink 3 hours before the study.
Position of the patient. The patient can lie in a comfortable position on the back. Under the head, you can put a small pillow, in the case of pronounced abdominal wall tension, the pad can also be placed under the patient's knees.
Apply gel along the midline of the abdomen approximately 15 cm down from the xiphoid process to the symphysis.
Scanning is best done at the inspiratory delay, the patient can also breathe calmly until a pathological area is identified that requires particularly careful examination.
Select the sensor. Use a 3.5 MHz sensor for adults. Use a 5 MHz sensor for children and lean adults.
Adjustment of sensitivity of the device.
Start the study by placing the sensor along the midline in the upper abdomen under the xiphoid process. Turn the sensor to the right until you get a picture of the liver; Adjust the sensitivity to obtain the optimum image.
Scanning techniques
Return the sensor to the middle line and move it slowly to the left until the tubular pulsating structure is visualized. Move on it to a level just below the navel, where aortic division is determined: aortic bifurcation.
Use a transverse scan to measure the diameter of the aorta at different levels. Visualize the iliac arteries by slightly tilting the sensor to the right or left downwards from the bifurcation of the aorta.
When detecting irregularities in the contour or other pathology, make transverse sections also higher and lower than the location of the revealed pathology. In elderly patients, the course of the aorta may be altered, some aortic displacement or a change in direction may be determined, but the diameter of the aorta should not vary significantly. If the aorta is not visualized through the anterior abdominal wall, conduct the study translumally in the direction of the left kidney.
Gas
When shielding with intestinal gas, gently push the sensor and change the scanning angle; Use oblique or lateral sections, if necessary, and cuts on both sides of the spine. Sometimes it is necessary to conduct a study in the patient's standing position to shift the gas filled intestine.
When scanning the aorta, it is necessary to visualize the celiac trunk and the superior mesenteric artery.