Abdominal aortic aneurysms: diagnostic review and new technique.

A new technique of computed tomography (CT) applied to the diagnosis of abdominal aortic aneurysms is described, and the experience in 58 patients is reviewed. In all instances the abdominal aorta was clearly demonstrated, even when wall calcification was absent. A series of 37 patients with abdominal aortic aneurysm underwent evaluation by physical examination, abdominal roentgenograms, and ultrasonic and CT scanning. Measurements of the transverse diameter at the point of maximal dilatation were compared with the measurements made at operation. CT not only confirmed the diagnosis in all patients but the measurements obtained by this technique were the most accurate, correlating extremely well with the true dimensions of the aneurysm. The addition of contrast enhancement to CT scanning allowed clear delineation of the aortic lumen and intraaneurysmal thrombus, not possible with any other method, including ultrasonography. The technique appears useful as a screening procedure and in the differential diagnosis of a tortuous abdominal aorta. Patients with a small aortic dilatation can be followed accurately by scanning.