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[Radiologic diagnosis of abdominal aortic aneurysm. Value of abdominal radiography, ultrasonic tomography and abdominal aortography].

Radiological diagnosis of arteriosclerotic abdominal aortic aneurysm is discussed. This review is based on the evaluation of 70 abdominal plain films and 58 aortograms. In addition, 11 aneurysms have been examined by ultrasound tomography (grey-scale technique). In 15% of patients referred with suspicion of aneurysm, the diagnosis could not be confirmed radiologically or operatively. The diagnosis of abdominal aortic aneurysm can be established in 80% of patients on the basis of the abdominal plain films. Ultrasonography gives better results as a screening method, since it renders a definite diagnosis possible in about 98% of cases and unnecessary arteriography can thus be avoided. However, preoperative abdominal aortography remains indispensable for demonstration of the exact anatomic details and pathologic changes in the large abdominal and pelvic arteries. The risk involved in this examination are minimal. Suprarenal or combined supra- and infrarenal aneurysm were found in 9% (5 patients), and renal artery stenosis or obstruction in 12% (7 cases). Obstruction or stenosis of the celiac artery and the superior mesenteric artery were present in only 2 patients with suprarenal expansion of the aneurysm. The angiographic-anatomic correlation is excellent, and only very infrequently is it impossible to determine exactly the distal extent of the aneurysm (2 patients).