Sonografie des abdominellen Aortenaneurysmas: Diagnose, Erkennen von Komplikationen und Nachkontrolle nach endovaskulärer Therapie

Kernaussagen

• B-Bild-US ist die Methode der Wahl in der Früherkennung und in der Diagnose des symptomatischen und asymptomatischen AAA.

• B-Bild-US ist die Methode der Wahl zur Verlaufsuntersuchung des AAA, um Patienten rechtzeitig bei Größenzunahme einer optimalen Therapie zuführen zu können.

• Größe (Durchmesser im Quer- und Längsschnitt), Bezug zu Nieren- und Viszeralarterien und der Aortenbifurkation, Wandthrombosierung und Lumenverlauf sind wesentliche Befundelemente in der Beschreibung eines AAA.

• In der Diagnose eines dissezierenden Aortenaneurysmas sind Farbdoppler und CEUS hilfreich. Die therapierelevante Information liefert aber die CT-Angiografie.

• Bei der US-Untersuchung des Abdomens sollte die Aorta abdominalis im Hinblick auf ein asymptomatisches AAA jeweils mituntersucht werden.

• Bei Männern zwischen 65 und 75 Jahren mit Raucheranamnese oder AAA in der Familienanamnese sollte die Aorta abdominalis mindestens einmal untersucht werden.

• Der CEUS ist eine treffsichere und schonende bildgebende Methode in der lebenslangen Verlaufskontrolle nach EVAR zur Diagnose und Charakterisierung von Endoleaks.

Main statements

• B-mode US is the method of choice for the early detection and diagnosis of symptomatic and asymptomatic AAA.

• B-mode US is the method of choice for AAA follow-up in order to be able to provide patients with optimum treatment in a timely manner in the case of an increase in size.

• Size (diameter in cross and longitudinal section), relationship to renal and visceral arteries and the aortic bifurcation, wall thrombosis, and lumen course are essential elements in the description of an AAA.

• Color Doppler and CEUS are useful for diagnosing a dissecting aortic aneurysm. CT angiography provides relevant treatment information.

• The abdominal aorta should be included in an US examination of the abdomen with respect to an asymptomatic AAA .

• The abdominal aorta should be examined at least once in men between 65 and 75 years of age with a history of smoking or a family history of AAA.

• CEUS is a reliable and safe imaging method for lifelong follow-up after EVAR with respect to the diagnosis and characterization of endoleaks.

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