II. Imaging: Standard Abdominal CT
- Indications
- Suboptimal Ultrasound of AAA
- Suspected hemodynamically stable ruptured AAA
- Advantages over Ultrasound
- Reproducible results without operator variation
- Defines surrounding periaortic anatomy
- Identifies AAA rupture
- Ultrasound is not adequate to diagnose AAA rupture (other than free fluid)
- Limitations
- Does not define periaortic Vascular Anatomy
III. Imaging: Helical CT (Spiral CT) or CT Angiography
- Indications
- Preoperative AAA evaluation
- Advantages
- Defines periaortic Vascular Anatomy
- Replaces Abdominal Aortography in most cases
- Noninvasive detailed vascular imaging
- Offers three dimensional reconstruction (CTA)
IV. Imaging: IV Contrast
- AAA diagnosis may be made on non-contrast CT (e.g. CT for Ureteral Stone)
- However, IV Contrast is recommended (esp. for surgical planning)
- Contrast is also needed to identify Aortic Dissection
V. Findings: Miscellaneous
- Mural thrombus
- Develops due to altered, turbulent vessel flow patterns in AAA (non-laminar flow)
VI. References
- Tubbs and Janicki (2025) Mastering Emergency Imaging, CCME, accessed 7/9/2026
- Sparks (2002) Am Fam Physician 65(8):1565-70 [PubMed]