Sonographic Indicator

The indicator, it is initially to the patient's right and again here we're fanning through the Aorta in a transverse view. And this is what we should be seeing on the screen. The indicator again towards the patient's right. Our major landmark is the Lumbar spine also known as the horseshoe spine. And sitting right on top of that is the Aorta towards the patient's left.

The IVC is another landmark to the patient's right. In this picture we can also see the Splenic vein and a little bit of a superior mesenteric artery.

This is an example of using color flow Doppler to make sure that you're looking at the Aorta. In this case we see the spine in post sterile part of the screen and we've used the color flow Doppler to pick up Aortic pulsations in the center of the screen. It may help to angle the probe slightly to pick up the color flow.

Once we're interrogated the Aorta in the transverse plane from the Celiac axis to the verification. We'd like to turn the probe clockwise, 90 degrees so that the indicator is towards the patient's head. And this will give us a Sagittal plane.

When we look on the screen, what we should using the Liver as a window, the Aorta which runs along the spine becoming more close to the abdominal walls. It goes distally. And in this case we can see the celiac artery, the first major branch of the Intra-abdominal Aorta followed in this case by the superior mesenteric artery traveling inferiorly.

When we're measuring the Aorta, we want to make sure that we include the entire wall, outside wall, the outside wall and this is generally to make sure that we don't underestimate the size of an Aneurysm. Normally Aorta is generally considered to be less than 3 centimeters from outside wall to outside wall. And this shows a correct measurement of the abdominal Aorta with a normal Aorta.

One of the things we need to be aware of, when we see an Abdominal Aortic Aneurysm as in this case is that the Lumen may look very anechoic, but there maybe Mural Thrombus or Otosclerosis on the outside of the Lumen, and this should be included when measuring the entire Aorta as that is part of the Aneurysm.