| Background and Objectives:The aorta is the conduit through which the blood ejected from the left ventricle isdelivered to the systemic arterial bed. An aneurysm of the aorta is localized,irreversible dilatation greater than50%of the normal width (diameter) of the aorta.Aortic aneurysm is being one of the increasing causes of death assuming that manycases go undiagnosed. Many patients are diagnosed as incidental finding while thepatients are imaged for other reasons. Men and elderly groups are prone to have aorticaneurysms. So, the objective of this study was to observe the presenting features,findings and the associated complications of aortic aneurysms in the patients of TheFirst Hospital of JiLin University.Methods and Material:All the participants with the diagnosis of aortic aneurysm were selected from theThe First Hospital of Jilin University. The patient’s data were collected from January2010to December2012on the basis of CT scan from PACS of this hospital. Total134patients were enrolled having aortic aneurysm in which2patients were havingtwo aortic aneurysms which were counted as separate patients, so making totalnumber of patients as136. Thoraco-abdominal aneurysms were placed as thoracic orabdominal aortic aneurysms according to its predominant portion located. Maximumtransverse diameter was measured for the size of aneurysms. All the patientsunderwent CT/CTA either by64slice MDCT or by64slice dual source CT scan. Thescan was carried out cranio-caudally from a level3cm above aortic arch to the levelof symphysis pubis.Result:Out of136aortic aneurysms studied, aneurysms were seen more in men with themale: female ratio of2:1. Male patients were found to have significantly biggerdiameter of aneurysm compared to female patients (6.14vs.5.28cm, p<0.05). Themean age of the patients was66.36±13.7years. The mean size of aneurysms was5.8±1.9cm. Thoracic and abdominal aortic aneurysms were seen in equal number ofpatients (n=68). Fusiform aneurysm was seen in69.1%(n=94) and saccular aneurysmwas seen in30.9%(n=42). True aneurysm was seen in66.2%(n=90) whilepseudoaneurysm was seen in33.8%(n=46). Calcification, thrombosis and rupture were seen in62.5%,51.5%and17.6%of patients respectively. Aortic aneurysm withthrombus thickness≥1.5cm was seen in21.3%(n=29). In the present study,51.4%(n=35) of thoracic aortic aneurysms and62.3%(n=43) of abdominal aortic aneurysmswere diagnosed on incidental finding. The age group of71~80years was found tohave maximum number of patients with aneurysm (33%) followed by age group of61~70yrs (30%). Abdominal aneurysm was seen more in61~80yrs of age group.Maximum patients with calcification was seen in age group>80yrs (11/13,84.6%),maximum thrombosis was seen in age group61~70yrs (27/41,65.8%) and maximumrupture was seen in age group41~50yrs (4/11,36.4%).The mean age of the patients with abdominal aortic aneurysm (AAA) wassignificantly higher compared to thoracic aortic aneurysm (TAA) group (69.75%vs.62.97%, p<0.01). True aneurysm was seen significantly more in AAA andpseudoaneurysm was seen more in TAA group (75%vs.57.4%,42.6%vs.25%,respectively; p<0.05). Fusiform aneurysm was seen more in AAA whereas saccularaneurysm was seen more in TAA (79.4%vs.58.8%,41.2%vs.20.6%, respectively,p<0.01). Calcification and thrombosis were significantly higher in AAA group thanTAA group (83.8%vs.41.2%, p<0.001;72.1%vs30.9%, p<0.001respectively).In comparing between true and pseudo aneurysms, mean age of the patients wassignificantly more in true aneurysm (69.2vs.60.8years, p<0.01) and rupture wasseen significantly more in pseudoaneurysm compare to true aneurysm (50%vs.1.1%,p<0.001).Comparing between true thoracic aortic aneurysms (TTAA) and pseudo thoracicaortic aneurysms (PTAA), calcification and thrombosis were significantly higher inPTAA group than TTAA group (69%vs.20.5%, p<0.001;48.3%vs.17.9%, p<0.01respectively). All the rupture were seen in PTAA group (41.4%vs.0%, p<0.001).While comparing between true abdominal aortic aneurysms (TAAA) and pseudoabdominal aortic aneurysms (PAAA), age was significantly higher in TAAA thanPAAA (72vs.63years, p<0.01). The mean size of aneurysm was more in PAAA thanTAAA (7.1vs.5.6cm, p<0.01). Calcification was seen more in TAAA group (92.2%vs.58.8%, p<0.01) whereas rupture was common in PAAA group (64.7%vs.2%,p<0.001).Thoracic aneurysms were commonly found to be <5cm in diameter whereasabdominal aneurysms were usually≥5cm in diameter (56.4%vs.28.6%,71.4%vs.43.6%, respectively, p<0.01). Calcification was significantly higher in those aneurysms with diameter≥5cm in compare to aneurysms <5cm in diameter (82.9%vs.23.2%, p<0.01).Though statistically not significant, distinction obtained by dual phase contrast-enhanced MSCT scan was seen more in rupture group in compared to non rupturegroup (71.4%vs.40.9%, p=0.171).Comparing the aneurysms associated with complications with the aneurysms notassociated with complications, age of the patients was significantly higher incomplications associated group (68.27vs.60.39years, p<0.01). Abdominal aneurysmwas seen more associated with complications in compared to thoracic aneurysms(65%vs.3%, p<0.001) and pseudoaneurysms were seen significantly more associatedwith complications in compared to true aneurysms (40.8%vs.12.1%, p<0.01).Thoracic aneurysm was seen significantly higher in patients with age <60yrs incomparison to patients with age>60yrs (75%vs.41%) and abdominal aneurysm wasseen more in elderly patients (59%vs.25%, p<0.001). True aneurysm was more inpatients with age≥60yrs (74%vs.44.4%) and pseudoaneurysm was seen more inpatients with age <60yrs (55.6%vs.26%, p<0.01). Calcification and thrombosis, bothwere significantly seen higher in elderly patients in comparison to relatively youngerpatients (72%vs.36.1%, p<0.001;60%vs.27.8%, p<0.01, respectively).The mean size of aneurysms that ruptured was6.36cm and it was seen that theaneurysms ruptured significantly more in the group where the diameter of theaneurysms were≥5cm in compare to aneurysms with diameter <5cm (p<0.05).Conclusion:CT/CTA is an optimal diagnostic tool for the diagnosis of aortic aneurysm andits complications. Dual phase CTA is useful for detecting stable, unstable andcomplicated aneurysm. The study of distribution of the types of aneurysm and sites ofaneurysm along with its occurrence in different age groups helps in anticipating thecomplications of aneurysm and thus helps in efficient management. |
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