Sidik Abubakar I, Al-Ariki Malik K, Shafii Abdulmajid Ilyas, Hossain Md Limon, Najneen Farjana, Ak Gulten, Ahlam Derrar, Shakiba Abdoli, Ghosh Debraj, Ajgar Bithi Mst Asia, Kairatuly Mussalim I
Cardiovascular Surgery, Peoples' Friendship University of Russia, Moscow, RUS.
Cardiothoracic Surgery, Peoples' Friendship University of Russia, Moscow, RUS.
Cureus. 2025 Mar 27;17(3):e81321. doi: 10.7759/cureus.81321. eCollection 2025 Mar.
Abdominal aortic aneurysm (AAA) is a potentially life-threatening vascular condition, with rupture carrying a high mortality risk. Advances in imaging technologies have significantly improved the detection, risk stratification, and management of AAA, necessitating periodic updates to international clinical guidelines. This review examines recent advancements in AAA imaging modalities, their role in diagnosis and risk assessment, and evolving screening strategies in response to changing epidemiological trends. A systematic literature search was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, identifying key studies on diagnostic imaging techniques such as ultrasonography (US), computed tomography angiography (CTA), magnetic resonance angiography (MRA), intravascular US (IVUS), positron emission tomography-computed tomography (PET-CT), and artificial intelligence (AI)-driven imaging. US remains the preferred screening tool due to its cost-effectiveness, while CTA is the gold standard for preoperative planning. MRA is an alternative for patients with renal impairment, and emerging technologies such as AI-based imaging, IVUS, and PET-CT enhance risk prediction and surgical decision-making. Declining AAA prevalence, attributed to reduced smoking rates and improved cardiovascular risk management, has led to a shift from population-wide screening to targeted screening based on individual risk factors. Additionally, the standardization of imaging protocols and caliper placement techniques is crucial for accurate measurements and consistent clinical decision-making. As imaging technology continues to evolve, integrating AI, genetic markers, and biomarkers into screening and diagnostic protocols may enable more precise and personalized AAA management. Future research should focus on refining imaging-based risk stratification models to optimize screening and treatment strategies.
腹主动脉瘤（AAA）是一种潜在的危及生命的血管疾病，破裂时具有很高的死亡风险。成像技术的进步显著改善了AAA的检测、风险分层和管理，因此国际临床指南需要定期更新。本综述探讨了AAA成像模式的最新进展、它们在诊断和风险评估中的作用，以及针对不断变化的流行病学趋势而不断演变的筛查策略。按照系统评价和Meta分析的首选报告项目（PRISMA）指南进行了系统的文献检索，确定了关于诊断成像技术的关键研究，如超声检查（US）、计算机断层血管造影（CTA）、磁共振血管造影（MRA）、血管内超声（IVUS）、正电子发射断层扫描-计算机断层扫描（PET-CT）和人工智能（AI）驱动的成像。由于其成本效益，US仍然是首选的筛查工具，而CTA是术前规划的金标准。MRA是肾功能损害患者的一种替代方法，基于AI的成像、IVUS和PET-CT等新兴技术可增强风险预测和手术决策。由于吸烟率降低和心血管风险管理改善，AAA患病率下降，导致筛查从全人群筛查转向基于个体风险因素的靶向筛查。此外，成像协议和卡尺放置技术的标准化对于准确测量和一致的临床决策至关重要。随着成像技术不断发展，将AI、遗传标记物和生物标志物整合到筛查和诊断协议中可能实现更精确和个性化的AAA管理。未来的研究应专注于完善基于成像的风险分层模型，以优化筛查和治疗策略。
