Abdominal aortic aneurysms that have ruptured or are at imminent risk of rupture

Abstract The rupture of an abdominal aortic aneurysm (AAA) is considered a high-risk surgical emergency, given the catastrophic consequences and high mortality rate. The objective of this pictorial essay is to illustrate the radiological signs that indicate rupture or imminent rupture. To that end, we describe cases treated at our facility and present a brief review of the literature on the topic. The clinical diagnosis of imminent AAA rupture can be difficult, because patients are usually asymptomatic or have nonspecific pain complaints. In the subsequent follow-up, it is possible to identify radiological signs that indicate instability or rupture itself and thus change the prognosis. Computed tomography is the modality of choice for evaluating an AAA and abdominal pain in the emergency setting. It is therefore essential that the radiologist immediately identify the imaging findings that indicate AAA rupture or the imminent risk of such rupture.

摘要：腹主动脉瘤（abdominal aortic aneurysm, AAA）破裂属于高危外科急症，因其可引发灾难性后果且死亡率居高不下。本影像图谱文章旨在阐明提示动脉瘤破裂或即将破裂的影像学征象。为此，我们将介绍本机构收治的相关病例，并对该主题的相关文献进行简要综述。腹主动脉瘤即将破裂的临床诊断颇具难度，因患者通常无明显症状，或仅表现为非特异性疼痛主诉。在后续随访过程中，可通过识别提示动脉瘤不稳定或已发生破裂的影像学征象，进而调整诊疗策略以改善患者预后。计算机断层扫描（Computed tomography, CT）是急诊场景下评估腹主动脉瘤与腹痛的首选检查手段。因此，放射科医师需即刻识别提示腹主动脉瘤破裂或存在此类破裂高危风险的影像学表现。