Screening for abdominal aortic aneurysms during routine lumbar CT scan: modification of the standard technique.
BACKGROUND
Abdominal aortic aneurysms (AAAs) are often incidental findings in patients undergoing US, CT or MRI studies. The recommended field of view (FOV) for standard CT examinations of the spine is 14 cm. This FOV does not allow full visualization of the abdominal aorta.


OBJECTIVE
To justify a larger FOV for male smokers older than 55 years and women older than 65 years, with a higher incidence of AAA.


METHODS
The lumbar CT examinations of 100 consecutive patients (age: mean 68 years, range 55-85 years) presented with low-back pain were retrospectively reviewed. Measurements of the abdominal aorta and lumbar abnormalities were analysed. A control study in 850 patients who underwent abdominal CT scans for other causes was available for comparison.


RESULTS
There were three men with AAAs measuring 4.5, 5.5 and 5.6 cm (mean 5.2 cm). Findings related to the clinical problem were disk prolapse or herniation, spondylosis, spinal stenosis and grade I spondylolesthesis. In the control group, 17 patients were found with AAAs with diameter greater than 4 cm (2%).


CONCLUSIONS
Patients with low-back pain, older than 55 years of age, examined with lumbar spine CT, should also be screened for aortic disease, since the prevalence of AAA is similar with that of an age-matched control group. Appropriate modification in the applied FOV is recommended.
Department of Radiology, CT/MRI Unit, Areteion Hospital, University of Athens Medical School, 76 Vas. Sophias Ave., GR-115 28 Athens, Greece. agouliam@aretaieio.uoa.gr
Athanassios D
AD
Gouliamos
Theodoros
T
Tsiganis
Panagiotis
P
Dimakakos
Lambros J
LJ
Vlahos
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D017116:Low Back Pain / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017678:Sex Distribution; D014057:Tomography, X-Ray Computed / Q000379:methods*