Aorta

Aorta

It lies just to the left of midline with the IVC on it's immediate right. The IVC will compress with transducer pressure but the aorta will not. Use colour Doppler to help visualise.Scan in longitudinal and transverse from the most proximal to below the bifurcation.Use slow graded compression to dispel the bowel gas with the patient supine initially.Begin with the patient supine. If you are having trouble, roll to left decubitus to use the liver as a window. Alternatively, roll the patient on their right side (particularly if they have a large apron of fat).It should be assessed from the diaphragm to below the iliac bifurcation.Measure:AP and transverse from outer to outer edge.

• Normal male < 3cm
• Normal female<2.5cm

If there is an aneurysm, measure:
• Length
• AP and Transverse diameters.
• Luminal diameter(if it contains thrombus)
• Distance from the renal arteries and bifurcation
• Measure the Iliacs for any involvement.
• Is it fusiform or saccular?

Be very careful to measure the aorta at its true axis and not oblique as a tortuous vessel may make this difficult.Check the aorta for any stenosis.Is there any plaque, is it calcified (atherosclerosis). Is the velocity >150cm/sec.Check for any surrounding lymph node enlargement making sure you apply compression so you don't be confused by bowel loops. Para aortic lymphadenopathy is suggestive of Kochs abdomen or malignancy.


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