title: A comparison of computed tomography, magnetic resonance imaging, and digital subtraction angiography findings in the diagnosis of infected aortic aneurysm.
abstract: 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.
authors.affiliation: Department of Radiology, Chi-Mei Foundation Medical Center, Liou Yin Campus, Yung Kang City, Tainan Hsien, Taiwan, Republic of China. linmikea@yahoo.com.tw
authors.forename: Ming-Pin
authors.initials: MP
authors.lastname: Lin
authors.forename: Shih-Chin
authors.initials: SC
authors.lastname: Chang
authors.forename: Reng-Hong
authors.initials: RH
authors.lastname: Wu
authors.forename: Chung-Kuao
authors.initials: CK
authors.lastname: Chou
authors.forename: Wen-Sheng
authors.initials: WS
authors.lastname: Tzeng
mesh_terms: 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*
chemical_list: D003287:Contrast Media