Participation on the expert panel does not necessarily imply endorsement of the final document by individual contributors or their respective organization. Reprint requests to: publications@acr.org All elements are essential: 1) timing, 2) reconstructions/reformats, and 3) 3-D renderings. Standard CTs with contrast also include timing issues and reconstructions/reformats. Only in CTA, however, is 3-D rendering a required element. This corresponds to the definitions that the CMS has applied to the Current Procedural Terminology codes. OR Discussion of Procedures by Variant Variant 1: Pulsatile abdominal mass, suspected abdominal aortic aneurysm. Initial imaging. Aortography Abdomen Although AAAs can be diagnosed by catheter-based aortography of the abdominal aorta, it is invasive and has low sensitivity [3,7]. The width of the contrast column on aortography may underestimate the true aortic diameter if there is significant mural thrombus obscuring the luminal contour of the aneurysm or if the 2-D image acquisition plane is not orthogonal to the plane of maximum aortic diameter. Aortography is the main diagnostic component of endovascular AAA interventions and may be particularly useful in emergent cases of ruptured AAA. CT Abdomen and Pelvis CT abdomen and pelvis with intravenous (IV) contrast, CT abdomen and pelvis without and with IV contrast, and CT abdomen and pelvis without IV contrast are noninvasive, fast, and commonly used to evaluate various abdominopelvic pathologies, including aortic and nonaortic causes of a pulsatile abdominal mass. There is no specific literature regarding aortic measurements on standard CT images, with or without IV contrast, for the initial imaging evaluation of suspected AAA; however, aortic diameters can be accurately assessed on CT images if the abdominal aortic contour is well visualized and can be distinguished from adjacent structures.
Pulsatile Abdominal Mass Suspected Abdominal Aortic Aneurysm. Participation on the expert panel does not necessarily imply endorsement of the final document by individual contributors or their respective organization. Reprint requests to: publications@acr.org All elements are essential: 1) timing, 2) reconstructions/reformats, and 3) 3-D renderings. Standard CTs with contrast also include timing issues and reconstructions/reformats. Only in CTA, however, is 3-D rendering a required element. This corresponds to the definitions that the CMS has applied to the Current Procedural Terminology codes. OR Discussion of Procedures by Variant Variant 1: Pulsatile abdominal mass, suspected abdominal aortic aneurysm. Initial imaging. Aortography Abdomen Although AAAs can be diagnosed by catheter-based aortography of the abdominal aorta, it is invasive and has low sensitivity [3,7]. The width of the contrast column on aortography may underestimate the true aortic diameter if there is significant mural thrombus obscuring the luminal contour of the aneurysm or if the 2-D image acquisition plane is not orthogonal to the plane of maximum aortic diameter. Aortography is the main diagnostic component of endovascular AAA interventions and may be particularly useful in emergent cases of ruptured AAA. CT Abdomen and Pelvis CT abdomen and pelvis with intravenous (IV) contrast, CT abdomen and pelvis without and with IV contrast, and CT abdomen and pelvis without IV contrast are noninvasive, fast, and commonly used to evaluate various abdominopelvic pathologies, including aortic and nonaortic causes of a pulsatile abdominal mass. There is no specific literature regarding aortic measurements on standard CT images, with or without IV contrast, for the initial imaging evaluation of suspected AAA; however, aortic diameters can be accurately assessed on CT images if the abdominal aortic contour is well visualized and can be distinguished from adjacent structures.