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Infected aortic aneurysms: imaging findings.

Thanila A Macedo1, Anthony W Stanson, Gustavo S Oderich

  • 1Department of Radiology and Division of Vascular Surgery, Mayo Clinic and Foundation, 200 First St SW, Rochester, MN 55905, USA. macedo.thanila@mayo.edu

Radiology
|April 8, 2004
PubMed
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Infected aortic aneurysms are often saccular with lobulated contours and may present with adjacent masses or fluid. Imaging findings like rapid expansion and unusual locations suggest infection.

Area of Science:

  • Radiology
  • Vascular Surgery
  • Infectious Diseases

Background:

  • Infected aortic aneurysms are rare but life-threatening conditions.
  • Accurate and timely diagnosis is crucial for effective treatment.
  • Imaging plays a key role in identifying characteristic features of infected aortic aneurysms.

Purpose of the Study:

  • To delineate the specific imaging characteristics of infected aortic aneurysms.
  • To differentiate infected aortic aneurysms from arteriosclerotic aneurysms based on imaging findings.
  • To establish imaging criteria suggestive of aortic aneurysm infection.

Main Methods:

  • Retrospective review of 31 infected aortic aneurysms in 29 patients over 25 years.
  • Analysis of computed tomographic (CT), arteriography, nuclear medicine, and magnetic resonance (MR) imaging studies.

Related Experiment Videos

  • Evaluation of aneurysm size, shape, location, branch involvement, calcification, gas, radiotracer uptake, and periaortic findings.

    • Main Results:

    • Infected aortic aneurysms were predominantly saccular (93%) and located in the infrarenal aorta (32%).
    • Associated findings included paraaortic soft-tissue mass/stranding/fluid (48%), rapid expansion, vertebral body destruction, and periaortic gas.
    • Angiography highlighted saccular morphology with lobulated contours; nuclear medicine showed increased activity in infected cases.

    Conclusions:

    • Saccular aneurysms with lobulated contours, rapid expansion, and adjacent masses/fluid are highly suspicious for infection.
    • Unusual locations combined with these imaging features increase suspicion for infected aortic aneurysms.
    • These imaging findings aid in the early diagnosis and management of infected aortic aneurysms.