Ultrasonography of the abdominal aorta: The right flank vs the epi-mesogastric windows

Abstract

Ultrasonography of the abdominal aorta should be performed as part of a complete echocardiographic study. As visualization may be difficult from the epi-mesogastric (E–M) window because of obesity or distension, we evaluated the feasibility of the right flank (RF) as an alternative acoustic window in 100 patients (62 male, 38 female, aged 7–83 years). Compared with the E–M window, our results showed that the right flank was significantly better in imaging of the infrarenal aorta: 89% (RF) vs 75% (E–M) (p < 0.05); right renal artery: 84% vs 71% (p < 0.05); and right renal artery Color Doppler: 84% vs 71% (p < 0.05). The Doppler sonification angle for the right proximal renal artery was 0°–31° (mean 12.7° ± 4.2°) vs 64°–76° (mean 70.6° ± 4.1°); for the left proximal renal artery 0°–35° (mean 23.1° ± 6.6°) vs 62°–73° (mean 68.3° ± 4.2°). Images obtained from the right flank were often of better quality than those obtained from the abdominal window because of a superior definition of acoustic interfaces and a better performance of Color Doppler sampling. Thus, the right flank could be considered a good alternative window for the echographic study of the abdominal aorta.