Iwakoshi Shinichi, Hirai Toshiko, Kichikawa Kimihiko
Department of Radiology, Nara Medical University, Kashihara, Nara, Japan.
Ann Vasc Dis. 2019 Sep 25;12(3):319-322. doi: 10.3400/avd.ra.19-00070.
Abdominal aortic aneurysms (AAAs) are life-threatening and are associated with >80% mortality when they rupture. Therefore, detecting these aneurysms before they rupture is critical. Ultrasonography is a non-invasive tool that is used for screening AAAs by measuring abdominal aorta diameter. A recent meta-analysis demonstrated the positive effects of ultrasonography. To date, aneurysm diameter is the most reliable predictor for aneurysm rupture and is used as a criterion for surgical intervention. However, some AAAs rupture at small diameters. Therefore, a better predictor for AAA rupture that is independent of aneurysm diameter is needed. Recently, an aortic wall strain examined using ultrasonography has been reported to have a potential in predicting AAA rupture. Since the introduction of endovascular aneurysm repair (EVAR), a paradigm shift has occurred in the management of AAAs. EVAR is broadly spread with the advantage of early favorable results but with concerning endoleak complications. At present, computed tomography angiography (CTA) is considered to be a gold standard for surveillance following EVAR, but it encounters some problems, such as contrast usage or radiation exposure. Ultrasonography offers an examination free from these problems and can this be an alternative to CTA. In this review article, current trends and new technologies regarding AAA assessment using ultrasonography are introduced.
腹主动脉瘤（AAA）会危及生命，破裂时死亡率超过80%。因此，在动脉瘤破裂前进行检测至关重要。超声检查是一种非侵入性工具，通过测量腹主动脉直径来筛查腹主动脉瘤。最近的一项荟萃分析证明了超声检查的积极作用。迄今为止，动脉瘤直径是动脉瘤破裂最可靠的预测指标，并被用作手术干预的标准。然而，一些腹主动脉瘤在直径较小时就会破裂。因此，需要一个独立于动脉瘤直径的更好的腹主动脉瘤破裂预测指标。最近，据报道，通过超声检查测量的主动脉壁应变在预测腹主动脉瘤破裂方面具有潜力。自从引入血管内动脉瘤修复术（EVAR）以来，腹主动脉瘤的治疗发生了范式转变。EVAR因其早期良好效果的优势而广泛应用，但存在内漏并发症问题。目前，计算机断层扫描血管造影（CTA）被认为是EVAR术后监测的金标准，但它存在一些问题，如使用造影剂或辐射暴露。超声检查不存在这些问题，可以作为CTA的替代方法。在这篇综述文章中，介绍了使用超声检查评估腹主动脉瘤的当前趋势和新技术。
