A comparison of computed tomography, magnetic resonance imaging, and digital subtraction angiography findings in the diagnosis of infected aortic aneurysm.
OBJECTIVE
To characterize imaging findings from computed tomography, magnetic resonance imaging, and angiogram in patients with infected aortic aneurysm.


METHODS
We retrospectively reviewed the records of 21 patients (men, 17; women, 4) with proven infected aortic aneurysms and compared the imaging findings (computed tomography scans, n = 21; magnetic resonance images, n = 2; and angiograms, n = 2).


RESULTS
Aneurysms were located in the descending thoracic aorta (n = 10; 47.6%), abdominal aorta (n = 6; 28.6%), aortic arch (n = 3; 14.3%), and thoracoabdominal aorta (n = 2; 9.5%). Aneurysms were saccular in 19 (90%) and fusiform in 2 (10%). Maximal diameters were greater than 10 cm in 2 patients (10%), 5 to 10 cm in 11 (52%), and less than 5 cm in 8 (38%). Average diameters were 6.5 cm in the aortic arch, 5.3 cm in the descending thoracic aorta, and 5.1 cm in the abdominal aorta. Obvious aortic wall calcification occurred in 19 patients (90%). Other features included disrupted calcification (n = 15; 71%), prominent and irregular wall thickening (n = 17; 81%), periaortic soft tissue mass (n = 15; 71%), rim enhancement (n = 18; 86%), periaortic gas (n = 7; 33%), periaortic stranding and fluid retention (n = 14; 67%), periaortic hematoma (n = 3; 14%), adjacent bone destruction (n = 1; 5%), pleural effusion (n = 12; 57%), and associated dissecting aneurysm (n = 2; 10%).


CONCLUSIONS
Saccular aneurysms, adjacent soft tissue masses, rim enhancement, stranding, fluid, gas, and unusual adjacent bony destruction highly suggest infected aneurysm.
Lin
Ming-Pin
MP
Department of Radiology, Chi-Mei Foundation Medical Center, Liou Yin Campus, Yung Kang City, Tainan Hsien, Taiwan, Republic of China. linmikea@yahoo.com.tw
Chang
Shih-Chin
SC
Wu
Reng-Hong
RH
Chou
Chung-Kuao
CK
Tzeng
Wen-Sheng
WS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000785:Aneurysm, Infected / Q000175:diagnosis*; D015901:Angiography, Digital Subtraction / Q000379:methods*; D001011:Aorta / Q000473:pathology; D001014:Aortic Aneurysm / Q000175:diagnosis*; D001027:Aortography / Q000379:methods; D003287:Contrast Media / Q000008:administration & dosage; D004927:Escherichia coli Infections / Q000175:diagnosis; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D021621:Imaging, Three-Dimensional; D007710:Klebsiella Infections / Q000175:diagnosis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016870:Neisseriaceae Infections / Q000175:diagnosis; D012189:Retrospective Studies; D012480:Salmonella Infections / Q000175:diagnosis; D013203:Staphylococcal Infections / Q000175:diagnosis; D013290:Streptococcal Infections / Q000175:diagnosis; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media