HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) CME Test (opens in a new window) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Rakita, D. Articles by Friedman, B. Search for Related Content PubMed PubMed Citation Articles by Rakita, D. Articles by Friedman, B. Related Collections Vascular and/or Interventional Radiology Computed Tomography

Spectrum of CT Findings in Rupture and Impending Rupture of Abdominal Aortic Aneurysms¹

¹ From the Department of Radiology, Division of Body Imaging and Division of Interventional Radiology, Long Island Jewish Medical Center, 270-05 76th Ave, New Hyde Park, NY 11040. Presented as an education exhibit at the 2005 RSNA Annual Meeting. Received March 16, 2006; revision requested June 14 and received August 4; accepted August 10. All authors have no financial relationships to disclose. Address correspondence to D.R. (e-mail: rakitamd{at}gmail.com).

Prompt diagnosis of rupture and impending rupture of abdominal aortic aneurysms is imperative. The computed tomographic (CT) findings of ruptured abdominal aortic aneurysms are often straightforward. Most ruptures are manifested as a retroperitoneal hematoma accompanied by an abdominal aortic aneurysm. Periaortic blood may extend into the perirenal space, the pararenal space, or both. Intraperitoneal extravasation may be an immediate or a delayed finding. Discontinuity of the aortic wall or a focal gap in otherwise continuous circumferential wall calcifications may point to the location of a rupture. There usually is a delay of several hours between the initial intramural hemorrhage and frank extravasation into the periaortic soft tissues. Contained or impending ruptures are more difficult to identify. A small amount of periaortic blood may be confused with the duodenum, perianeurysmal fibrosis, or adenopathy. Imaging features suggestive of instability or impending rupture include increased aneurysm size, a low thrombus-to-lumen ratio, and hemorrhage into a mural thrombus. A peripheral crescent-shaped area of hyperattenuation within an abdominal aortic aneurysm represents an acute intramural hemorrhage and is another CT sign of impending rupture. Draping of the posterior aspect of an aneurysmal aorta over the vertebrae is associated with a contained rupture.

© RSNA, 2007