Lumbar Spine MRI: Missed Opportunities for Abdominal Aortic Aneurysm Detection.

Autor: Zucker EJ; Department of Radiology, Stanford University School of Medicine, Stanford, CA. Electronic address: zucker@post.harvard.edu., Prabhakar AM; Division of Emergency Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Radiology, Newton-Wellesley Hospital, Newton, MA.
Jazyk: angličtina
Zdroj: Current problems in diagnostic radiology [Curr Probl Diagn Radiol] 2020 Jul - Aug; Vol. 49 (4), pp. 254-259. Date of Electronic Publication: 2019 May 09.
DOI: 10.1067/j.cpradiol.2019.05.002
Abstrakt: Purpose: The US Preventive Services Task Force (USPSTF) recommends 1-time sonographic screening for abdominal aortic aneurysms (AAAs) in male smokers ages 65-75 and other selected individuals in this age group based on risk factors. Patients in this age range are frequent utilizers of lumbar spine MRI, in which the abdominal aorta is typically fully imaged. The purpose of this study was to assess the potential detection rate of AAAs on lumbar spine MRI performed in the USPSTF screening age range with systematic aortic measurement and the frequency with which AAAs are currently reported in practice.
Materials and Methods: All consecutive lumbar spine MRI exams performed without contrast at a single academic tertiary care center over a 1-year period (4/1/2016-3/31/2017) in patients ages 65-75 were retrospectively reviewed. Maximal anteroposterior, and transverse dimensions of the abdominal aorta were measured using axial T2-weighted images, supplemented with sagittal T2-weighted images if assessment was limited by field-of-view or artifact. The detection rate of AAA, defined as dilation of the aorta to a diameter of ≥3 cm, size of AAAs detected, and frequency with which AAAs were reported, were assessed. Differences in aortic diameters and aneurysm detection rates between genders were compared with the unpaired 2-sample t test.
Results: Three hundred and ninety-five lumbar spine MRIs were reviewed, 240 (60.8%) in women and 155 (39.2%) in men, with mean ± standard deviation (SD) age of 70.2 ± 3.2 years. AAAs were detected in 38/395 (9.6%) cases, most (33/38, 86.8%) of which were <4 cm. Of these, only 4 (10.5%) were reported by the interpreting radiologist; 3/4 (75%) corresponded to aneurysms ≥4 cm.
Conclusion: Lumbar spine MRI performed in the USPSTF AAA screening age range, especially in men, facilitates frequent detection of AAA when the aorta is systematically measured. However, in typical lumbar spine assessment, AAAs are often underreported, particularly for smaller aneurysms.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: