Overview of common errors and pitfalls to avoid in the acquisition and interpretation of ultrasound imaging of the abdominal aorta

Figures & data

Figure 1 (A) Axial and (B) sagittal ultrasound images of a 6 cm abdominal aortic aneurysm with endovascular stent.

Figure 2 Axial ultrasound image of an abdominal aortic aneurysm with thrombus, demonstrating the three common methods to measure the aorta AP diameter.

Notes: (A) ITI, (B) LELE and (C) OTO.
Abbreviations: AP, anteroposterior; ITI, inner-to-inner; LELE, leading edge-to-leading edge; OTO, outer-to-outer.

Figure 3 Ultrasound of an AAA in the axial plane.

Notes: (A) The OTO AP measurement correctly identifies the 8.9 cm AAA. (B) The ITI measurement may inadvertently underestimate an aneurysm and mural thrombus.
Abbreviations: AAA, abdominal aortic aneurysm; AP, anteroposterior; ITI, inner-to-inner; OTO, outer-to-outer.

Figure 4 The cylinder tangent effect.

Note: (A) A longitudinal beam through the center of the aorta will provide the maximal AP diameter, whereas (B) a beam off to the side or tangent will result in a falsely smaller diameter.
Abbreviation: AP, anteroposterior.

Figure 5 Axial ultrasound image of the abdominal aorta with inappropriate depth on the monitor where the spinal canal (*) is visualized on the center of the screen.

Notes: The aorta is correctly identified and measured in the near field.
Abbreviations: Ao, abdominal aorta; I, inferior vena cava.