Role of CT in the preoperative assessment of abdominal aortic aneurysms

The files of 50 consecutive patients (1987-89) operated for abdominal aortic aneurysm (AAA) and examined with CT were studied. The criteria for inclusion were surgical features. - CT can be made more accurate for the study of AAA: - Thus the location of the neck of the aneurysm relative to the renal arteries was defined in 94% of all cases. - In addition, CT yields information about the wall of the aneurysm, whether it be thickened (3 inflammatory aneurysms were properly diagnosed) or, more importantly, weakened (solution of continuity in the wall in the prior-to-rupture appearance). - Owing to the quality of its performances and to its noninvasive character, CT with contrast injection was regarded as an essential technique for the preoperative assessment of abdominal aortic aneurysm in most cases. The examination must be carried out strictly, especially for the contiguous sections of the renal arteries and their extension to the crural arch. - As it demonstrates weakened areas more easily, a more accurate study of the aneurysmal wall with CT might increase the surgical indications for some smaller aneurysms, the potential evolution of which does not seem to be associated with their diameter only