Brewster D C, Darling R C, Raines J K, Sarno R, O'Donnell T F, Ezpeleta M, Athanasoulis C
Circulation. 1977 Sep;56(3 Suppl):II164-9.
Because of the importance of size in the decision for elective operation in patients with abdominal aortic aneurysm (AAA) and the need to identify accurately even small aneurysms, a prospective study was carried out to compare currently available diagnostic methods. A series of 78 patients with AAA underwent evaluation by physical examination, lateral lumbar spine X-ray, aortic ultrasound, and aortography. Measurements were compared to aneurysm size at operation. Physical examination was most variable, and tended to overestimate size by approximately 20%. Lateral spine X-ray was useful in three of every four patients and in these cases it was reliable and reasonably accurate. Ultrasonography was most widely applicable and very reliable for diagnosis. Its tendency to underestimate aneurysm size in our experience may be improved by use of gray-scale units, which better define aneurysm wall thickness. The anatomic information provided by aortography was of great value in the surgical management of patients with AAA, but aortography was of limited value in accurate measurement and should not be employed for this purpose.
由于动脉瘤大小在腹主动脉瘤（AAA）患者择期手术决策中具有重要意义，且需要准确识别甚至是小动脉瘤，因此开展了一项前瞻性研究以比较目前可用的诊断方法。78例AAA患者接受了体格检查、腰椎侧位X线检查、主动脉超声检查和主动脉造影评估。将测量结果与手术时的动脉瘤大小进行比较。体格检查的差异最大，往往会高估动脉瘤大小约20%。每四名患者中有三名患者的腰椎侧位X线检查有用，在这些病例中，该检查可靠且相当准确。超声检查应用最广泛，诊断非常可靠。根据我们的经验，使用灰度单位可能会改善其低估动脉瘤大小的倾向，灰度单位能更好地界定动脉瘤壁厚度。主动脉造影提供的解剖信息在AAA患者的手术管理中具有重要价值，但主动脉造影在精确测量方面价值有限，不应为此目的使用。
