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Features of infective native aortic aneurysms on computed tomography

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Jutidamrongphan, Warissara ; Kritpracha, Boonprasit ; Sörelius, Karl ; Hongsakul, Keerati ; Suwannanon, Ruedeekorn. / Features of infective native aortic aneurysms on computed tomography. In: Insights into Imaging. 2022 ; Vol. 13, No. 1.

Bibtex

@article{d82a89e46fc648cd81f9e2cdaafc9cee,
title = "Features of infective native aortic aneurysms on computed tomography",
abstract = "Background: Infective native aortic aneurysm (INAA) is a rare clinical diagnosis. The purpose of this study was to describe the CT findings of INAAs in detail. Methods: This was a retrospective single-center study of INAA patients at a major referral hospital between 2005 and 2020. All images were reviewed according to a protocol consisting of aneurysm features, periaortic findings, and associated surrounding structures. Results: One hundred and fourteen patients (mean age, 66 years [standard deviation, 11 years]; 91 men) with 132 aneurysms were included. The most common locations were infrarenal (50.8%), aortoiliac (15.2%), and juxtarenal (12.9%). The mean transaxial diameter was 6.2 cm. Most INAAs were saccular (87.9%) and multilobulated (91.7%). Calcified aortic plaque was present in 93.2% and within the aneurysm in 51.5%. INAA instability was classified as contained rupture (27.3%), impending rupture (26.5%), and free rupture (3.8%). Rapid expansion was demonstrated in 13 of 14 (92.9%) aneurysms with sequential CT studies. Periaortic inflammation was demonstrated as periaortic enhancement (94.7%), fat stranding (93.9%), soft-tissue mass (92.4%), and lymphadenopathy (62.1%). Surrounding involvement included psoas muscle (17.8%), spondylitis (11.4%), and perinephric region (2.8%). Twelve patients demonstrated thoracic and abdominal INAA complications: fistulas to the esophagus (20%), bronchus (16%), bowel (1.9%), and inferior vena cava (IVC) (0.9%). Conclusion: The most common CT features of INAA were saccular aneurysm, multilobulation, and calcified plaques. The most frequent periaortic findings were enhancement, fat stranding, and soft-tissue mass. Surrounding involvement, including psoas muscle, IVC, gastrointestinal tract, and bronchi, was infrequent but may develop as critical INAA complications.",
keywords = "Aortic aneurysm, Computed tomography, Infected aortic aneurysm, Infective native aortic aneurysm, Mycotic aortic aneurysm",
author = "Warissara Jutidamrongphan and Boonprasit Kritpracha and Karl S{\"o}relius and Keerati Hongsakul and Ruedeekorn Suwannanon",
note = "Publisher Copyright: {\textcopyright} 2021, The Author(s).",
year = "2022",
month = dec,
doi = "10.1186/s13244-021-01135-x",
language = "English",
volume = "13",
journal = "Insights into Imaging",
issn = "1869-4101",
publisher = "Springer Science and Business Media Deutschland GmbH",
number = "1",

}

RIS

TY - JOUR

T1 - Features of infective native aortic aneurysms on computed tomography

AU - Jutidamrongphan, Warissara

AU - Kritpracha, Boonprasit

AU - Sörelius, Karl

AU - Hongsakul, Keerati

AU - Suwannanon, Ruedeekorn

N1 - Publisher Copyright: © 2021, The Author(s).

PY - 2022/12

Y1 - 2022/12

N2 - Background: Infective native aortic aneurysm (INAA) is a rare clinical diagnosis. The purpose of this study was to describe the CT findings of INAAs in detail. Methods: This was a retrospective single-center study of INAA patients at a major referral hospital between 2005 and 2020. All images were reviewed according to a protocol consisting of aneurysm features, periaortic findings, and associated surrounding structures. Results: One hundred and fourteen patients (mean age, 66 years [standard deviation, 11 years]; 91 men) with 132 aneurysms were included. The most common locations were infrarenal (50.8%), aortoiliac (15.2%), and juxtarenal (12.9%). The mean transaxial diameter was 6.2 cm. Most INAAs were saccular (87.9%) and multilobulated (91.7%). Calcified aortic plaque was present in 93.2% and within the aneurysm in 51.5%. INAA instability was classified as contained rupture (27.3%), impending rupture (26.5%), and free rupture (3.8%). Rapid expansion was demonstrated in 13 of 14 (92.9%) aneurysms with sequential CT studies. Periaortic inflammation was demonstrated as periaortic enhancement (94.7%), fat stranding (93.9%), soft-tissue mass (92.4%), and lymphadenopathy (62.1%). Surrounding involvement included psoas muscle (17.8%), spondylitis (11.4%), and perinephric region (2.8%). Twelve patients demonstrated thoracic and abdominal INAA complications: fistulas to the esophagus (20%), bronchus (16%), bowel (1.9%), and inferior vena cava (IVC) (0.9%). Conclusion: The most common CT features of INAA were saccular aneurysm, multilobulation, and calcified plaques. The most frequent periaortic findings were enhancement, fat stranding, and soft-tissue mass. Surrounding involvement, including psoas muscle, IVC, gastrointestinal tract, and bronchi, was infrequent but may develop as critical INAA complications.

AB - Background: Infective native aortic aneurysm (INAA) is a rare clinical diagnosis. The purpose of this study was to describe the CT findings of INAAs in detail. Methods: This was a retrospective single-center study of INAA patients at a major referral hospital between 2005 and 2020. All images were reviewed according to a protocol consisting of aneurysm features, periaortic findings, and associated surrounding structures. Results: One hundred and fourteen patients (mean age, 66 years [standard deviation, 11 years]; 91 men) with 132 aneurysms were included. The most common locations were infrarenal (50.8%), aortoiliac (15.2%), and juxtarenal (12.9%). The mean transaxial diameter was 6.2 cm. Most INAAs were saccular (87.9%) and multilobulated (91.7%). Calcified aortic plaque was present in 93.2% and within the aneurysm in 51.5%. INAA instability was classified as contained rupture (27.3%), impending rupture (26.5%), and free rupture (3.8%). Rapid expansion was demonstrated in 13 of 14 (92.9%) aneurysms with sequential CT studies. Periaortic inflammation was demonstrated as periaortic enhancement (94.7%), fat stranding (93.9%), soft-tissue mass (92.4%), and lymphadenopathy (62.1%). Surrounding involvement included psoas muscle (17.8%), spondylitis (11.4%), and perinephric region (2.8%). Twelve patients demonstrated thoracic and abdominal INAA complications: fistulas to the esophagus (20%), bronchus (16%), bowel (1.9%), and inferior vena cava (IVC) (0.9%). Conclusion: The most common CT features of INAA were saccular aneurysm, multilobulation, and calcified plaques. The most frequent periaortic findings were enhancement, fat stranding, and soft-tissue mass. Surrounding involvement, including psoas muscle, IVC, gastrointestinal tract, and bronchi, was infrequent but may develop as critical INAA complications.

KW - Aortic aneurysm

KW - Computed tomography

KW - Infected aortic aneurysm

KW - Infective native aortic aneurysm

KW - Mycotic aortic aneurysm

UR - http://www.scopus.com/inward/record.url?scp=85122750692&partnerID=8YFLogxK

U2 - 10.1186/s13244-021-01135-x

DO - 10.1186/s13244-021-01135-x

M3 - Journal article

C2 - 35000044

AN - SCOPUS:85122750692

VL - 13

JO - Insights into Imaging

JF - Insights into Imaging

SN - 1869-4101

IS - 1

M1 - 2

ER -

ID: 79476890