{"id":102,"date":"2023-12-17T05:54:06","date_gmt":"2023-12-17T05:54:06","guid":{"rendered":"https:\/\/openbook.ums.edu.my\/shaipointofcareultrasoundforundergraduates\/chapter\/section-2-ultrasound-techniques-for-the-aorta\/"},"modified":"2024-09-19T04:00:09","modified_gmt":"2024-09-19T04:00:09","slug":"section-2-ultrasound-techniques-for-the-aorta","status":"publish","type":"chapter","link":"https:\/\/openbook.ums.edu.my\/pointofcareultrasoundforundergraduates\/chapter\/section-2-ultrasound-techniques-for-the-aorta\/","title":{"raw":"Ultrasound Techniques for the Aorta","rendered":"Ultrasound Techniques for the Aorta"},"content":{"raw":"

Ultrasound of the aorta involves scanning at several places to get the best view of the overall aorta regions.<\/p>\r\n

The techniques of getting adequate views of the aorta are described in the tables below<\/p>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
Aspect<\/strong><\/td>\r\nDetails<\/strong><\/td>\r\n<\/tr>\r\n<\/thead>\r\n
Segments<\/strong><\/td>\r\nAscending aorta, aortic arch, descending thoracic aorta, abdominal aorta<\/td>\r\n<\/tr>\r\n
Branches<\/strong><\/td>\r\nCoronary arteries, brachiocephalic trunk, left common carotid artery, left subclavian artery<\/td>\r\n<\/tr>\r\n
Indications<\/strong><\/td>\r\nSuspected Aortic Aneurysm, Aortic Dissection, Trauma<\/td>\r\n<\/tr>\r\n
Landmark Summary<\/strong><\/td>\r\nAscending Aorta (parasternal long-axis view), Aortic Arch (suprasternal notch view), Abdominal Aorta (subxiphoid\/transabdominal)<\/td>\r\n<\/tr>\r\n
Probe Selection<\/strong><\/td>\r\nPhased Array Probe (thoracic aorta), Curvilinear Probe (abdominal aorta)<\/td>\r\n<\/tr>\r\n
Structures Identified<\/strong><\/td>\r\nAortic Wall, Lumen, Branches<\/td>\r\n<\/tr>\r\n
Normal Findings<\/strong><\/td>\r\nUniform diameter, no wall thickening, or intraluminal masses<\/td>\r\n<\/tr>\r\n
Pathological Findings<\/strong><\/td>\r\nAneurysm, Dissection, Thrombus<\/td>\r\n<\/tr>\r\n
Image Windows\/Techniques<\/strong><\/td>\r\nTransducer Placement, Depth and Gain Adjustments<\/td>\r\n<\/tr>\r\n
Sonographic Findings<\/strong><\/td>\r\nAneurysm (aortic diameter measurement), Dissection (intimal flap identification), Wall Abnormalities (thickness\/irregularities)<\/td>\r\n<\/tr>\r\n
Pathological Sonographic Findings<\/strong><\/td>\r\nAAA, Thoracic Aortic Aneurysm, Dissection (presence of flap separating lumens)<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
Aspect<\/strong><\/td>\r\nTransverse View<\/strong><\/td>\r\nLongitudinal View<\/strong><\/td>\r\n<\/tr>\r\n<\/thead>\r\n
Probe Placement<\/strong><\/td>\r\nPerpendicular to the abdomen, above the umbilicus, orientation marker to the patient's right<\/td>\r\nParallel to the aorta, with orientation marker pointing cephalad (towards the patient's head)<\/td>\r\n<\/tr>\r\n
Objective<\/strong><\/td>\r\nVisualize the aorta in a cross-sectional view<\/td>\r\nAssess the aorta in its long axis<\/td>\r\n<\/tr>\r\n
Technique<\/strong><\/td>\r\nSweeping from xiphoid to umbilicus, adjusting depth and gain<\/td>\r\nSlide and tilt along the midline, maintaining longitudinal view, with similar depth and gain adjustments<\/td>\r\n<\/tr>\r\n
Segmental Assessment<\/strong><\/td>\r\nProximal Segment<\/strong> (below diaphragm to SMA origin): Evaluate for proximal aneurysms and dissection. Middle Segment<\/strong> (SMA to renal arteries): Check for aneurysms, atherosclerotic changes, and renal artery origins. Distal Segment<\/strong> (renal arteries to bifurcation): Assess for infrarenal aneurysms and bifurcation.<\/td>\r\nSimilar to transverse, with emphasis on the length and continuity of the aorta.<\/td>\r\n<\/tr>\r\n
Image Criteria<\/strong><\/td>\r\nMeasure outer-to-outer wall diameter and observe wall characteristics, lumen appearance, and pathology detection (aneurysms, dissections)<\/td>\r\nSimilar criteria as in transverse view, focusing on longitudinal diameter, wall and lumen evaluation<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n

Other techniques, such as colour Doppler, can be used in addition to these basic views to provide a more complete blood flow assessment and identify any vascular anomalies. Colour Doppler can measure flow dynamics and distinguish between true and false lumens in aortic dissection cases.<\/p>\r\n

[h5p id=\"9\"]<\/p>\r\n

The interactive video above is a simple tutorial on how to carry out Abdominal Aorta Scan. Adapted from \"Video 17 Tutorial on ultrasound for abdominal aortic aneurysm<\/a>\"\u00a0by\u00a0International Emergency Medicine Education Project<\/a>\u00a0is licensed under\u00a0CC BY 4.0<\/a><\/p>","rendered":"

Ultrasound of the aorta involves scanning at several places to get the best view of the overall aorta regions.<\/p>\n

The techniques of getting adequate views of the aorta are described in the tables below<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Aspect<\/strong><\/td>\nDetails<\/strong><\/td>\n<\/tr>\n<\/thead>\n
Segments<\/strong><\/td>\nAscending aorta, aortic arch, descending thoracic aorta, abdominal aorta<\/td>\n<\/tr>\n
Branches<\/strong><\/td>\nCoronary arteries, brachiocephalic trunk, left common carotid artery, left subclavian artery<\/td>\n<\/tr>\n
Indications<\/strong><\/td>\nSuspected Aortic Aneurysm, Aortic Dissection, Trauma<\/td>\n<\/tr>\n
Landmark Summary<\/strong><\/td>\nAscending Aorta (parasternal long-axis view), Aortic Arch (suprasternal notch view), Abdominal Aorta (subxiphoid\/transabdominal)<\/td>\n<\/tr>\n
Probe Selection<\/strong><\/td>\nPhased Array Probe (thoracic aorta), Curvilinear Probe (abdominal aorta)<\/td>\n<\/tr>\n
Structures Identified<\/strong><\/td>\nAortic Wall, Lumen, Branches<\/td>\n<\/tr>\n
Normal Findings<\/strong><\/td>\nUniform diameter, no wall thickening, or intraluminal masses<\/td>\n<\/tr>\n
Pathological Findings<\/strong><\/td>\nAneurysm, Dissection, Thrombus<\/td>\n<\/tr>\n
Image Windows\/Techniques<\/strong><\/td>\nTransducer Placement, Depth and Gain Adjustments<\/td>\n<\/tr>\n
Sonographic Findings<\/strong><\/td>\nAneurysm (aortic diameter measurement), Dissection (intimal flap identification), Wall Abnormalities (thickness\/irregularities)<\/td>\n<\/tr>\n
Pathological Sonographic Findings<\/strong><\/td>\nAAA, Thoracic Aortic Aneurysm, Dissection (presence of flap separating lumens)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n\n\n\n\n\n\n
Aspect<\/strong><\/td>\nTransverse View<\/strong><\/td>\nLongitudinal View<\/strong><\/td>\n<\/tr>\n<\/thead>\n
Probe Placement<\/strong><\/td>\nPerpendicular to the abdomen, above the umbilicus, orientation marker to the patient’s right<\/td>\nParallel to the aorta, with orientation marker pointing cephalad (towards the patient’s head)<\/td>\n<\/tr>\n
Objective<\/strong><\/td>\nVisualize the aorta in a cross-sectional view<\/td>\nAssess the aorta in its long axis<\/td>\n<\/tr>\n
Technique<\/strong><\/td>\nSweeping from xiphoid to umbilicus, adjusting depth and gain<\/td>\nSlide and tilt along the midline, maintaining longitudinal view, with similar depth and gain adjustments<\/td>\n<\/tr>\n
Segmental Assessment<\/strong><\/td>\nProximal Segment<\/strong> (below diaphragm to SMA origin): Evaluate for proximal aneurysms and dissection. Middle Segment<\/strong> (SMA to renal arteries): Check for aneurysms, atherosclerotic changes, and renal artery origins. Distal Segment<\/strong> (renal arteries to bifurcation): Assess for infrarenal aneurysms and bifurcation.<\/td>\nSimilar to transverse, with emphasis on the length and continuity of the aorta.<\/td>\n<\/tr>\n
Image Criteria<\/strong><\/td>\nMeasure outer-to-outer wall diameter and observe wall characteristics, lumen appearance, and pathology detection (aneurysms, dissections)<\/td>\nSimilar criteria as in transverse view, focusing on longitudinal diameter, wall and lumen evaluation<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Other techniques, such as colour Doppler, can be used in addition to these basic views to provide a more complete blood flow assessment and identify any vascular anomalies. Colour Doppler can measure flow dynamics and distinguish between true and false lumens in aortic dissection cases.<\/p>\n

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