In abdominal sonography aorta may be sighted from upper epigastrium to iliac artery bifurcation. The view is possible in both sagittal and transverse section.
Proportions:
Normal diameter: under 25 mm
Ectasia: 25-30 mm
Aneurysm: over 30 mm
Classic transverse look on aorta in the epigastric area
Longitudinal lateral (sagittal) view of the upper abdominal aorta. Besides the aorta and the liver in this view we can differentiate celiac artery and the separation of the superior mesenteric artery below.
Atherosclerosis – We can see ultrasound of an atherosclerotic plaque with calcification as grey bodies in the aortic lumen. This is a frequent finding in elderly patients.
Atherosclerosis of the aorta - We see a hyperechogenic line (aortic wall)
anechogenic lumen and a grey mass (atherosclerotic plaque)
Aortic Aneurysm - Abdominal aortic aneurysm is probably the most significant and most common finding. We must determine its longitudinal length, maximum diameter and its possible spread to outgoing vessels. It is important to know that the aneurysm is often filled by a thrombus. While the lumen of the aorta is anechogenic, thrombus appears as a hypoechogenic grey formation.
Aortic Aneurysm - Longitudinal view of the saccular aortic dilatation
Aortic aneurysm - Transverse view of the aneurysm (circled). Actual "free" lumen, however,
is only a small portion of the aorta (anechogenic part of the aorta, the dash line shows
its diameter) . The rest of the aortic cavity is filled with a thrombus.
Aortic dissection - Probe shows two cavities inside aorta. One is the real (initial) lumen and the other was created newly by the blood flowing into the wall of the aorta.
Aortic dissection - In the sagittal section we see 2 cavities, one of
them originated from blood flow penetration into the aortic wall.
