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Infected aortic aneurysms: CT appearance
1Department of Diagnostic Radiology, Northwestern University Medical School, Chicago, IL.
Abstract:
Three patients with infected (mycotic) aortic aneurysms were diagnosed primarily by CT. In two patients findings included the presence of a saccular aneurysm with an irregular lumen, perianeurysmal fluid, gas and/or hematoma, osteomyelitis in adjacent vertebral bodies, and disruption of intimal calcification. In one patient with sepsis there was rapid development of an aortic aneurysm. Computed tomography is of substantial benefit in the identification and characterization of infected aortic aneurysms. Certain features may strongly suggest the diagnosis without use of aortography.
Insights
Computed tomography (CT) effectively diagnoses infected aortic aneurysms by identifying key features like perianeurysmal fluid and osteomyelitis, often negating the need for aortography.
Area of Science:
- Radiology
- Vascular Surgery
- Infectious Diseases
Background:
- Infected (mycotic) aortic aneurysms are rare but life-threatening conditions.
- Early and accurate diagnosis is crucial for effective management and improved patient outcomes.
Observation:
- This study details the diagnostic utility of computed tomography (CT) in three patients with mycotic aortic aneurysms.
- CT imaging was the primary diagnostic tool used for all patients.
Findings:
- CT revealed characteristic features including saccular aneurysms with irregular lumens, perianeurysmal fluid, gas, or hematoma.
- Adjacent osteomyelitis of vertebral bodies and disrupted intimal calcification were noted in two cases.
- Rapid aneurysm development was observed in a patient with sepsis, highlighting the aggressive nature of the condition.
Implications:
- CT provides substantial benefit in identifying and characterizing infected aortic aneurysms.
- Specific CT findings can strongly suggest the diagnosis, potentially obviating the need for invasive aortography.
- Enhanced CT imaging improves diagnostic accuracy for mycotic aortic aneurysms, guiding timely surgical and medical interventions.