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  #1  
Old 04-22-2011
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Question Diagnosis of Abdominal Aneurysm?

A 16 year old boy who has been well presents for routine physical examination. A fixed mass is found in the midline in the central region of the abdomen at the level of L3 to L5. The pulsatile mass measures 6 cm in the longitudinal diameter and 4 cm in the horizontal diameter. It pulsates at the same rate as the heart beat. There is no tenderness.

Which of the following is the best method for investigating this mass?
A. Upper Gastrointestinal Endoscopy
B. Ultrasonography
C. CAT Scan
D. MRI
E. Barium Swallow
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Old 04-22-2011
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hmmm.........
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Old 04-23-2011
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i think c......
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Old 04-23-2011
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Default MRI is the best to see anatomy and inflammatory change

Radiologic investigation of abdominal aortic aneurysm disease: comparison of three modalities in staging and the detection of inflammatory change. (US, CT and MRI)


Our results suggest that MRI is superior to other methods in identifying the anatomy of aneurysms and the presence of inflammatory change

http://www.ncbi.nlm.nih.gov/pubmed/8464089

In my opinion, it depends on what you like to know-ultrasound is in-expensive and easily available to get the diagnosis. But if you like to know more details, pre-op etc., then need MRI.
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Old 04-23-2011
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in KLN for surgery, under the topic vascular surgery, they said use a sonogram for abdominal aorta aneurysm (or a CT scan)...

so in this case i tot of going with the USG... anyone else agree?
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Old 04-23-2011
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as far as the given options are concerned my answer would be CT. well in my hospital we used to order duplex US.... my answer would be CT !
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Old 04-23-2011
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Quote:
Originally Posted by Seetal View Post
in KLN for surgery, under the topic vascular surgery, they said use a sonogram for abdominal aorta aneurysm (or a CT scan)...

so in this case i tot of going with the USG... anyone else agree?
USG would be the best initial test for AAA but it wont be the best investigation..it would either be CT or MRI depending upon what the studies have shown to be a better investigation
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Old 04-23-2011
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best ans is C.......this is clear cut case of abdominal aneurysm ...best diagnosed by CT scan..........
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Old 04-23-2011
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Default Well

D .. most invasive.. but the best.. its should be angiography.. MRA
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Old 04-23-2011
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clear cut answer MRI in the aortic disease section
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Old 04-23-2011
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so u guys dont agree with KLN going for a USG first being that its inexpensive?
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Old 04-23-2011
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Quote:
Originally Posted by Seetal View Post
so u guys dont agree with KLN going for a USG first being that its inexpensive?
I think the best Initial investigation would be USG, especially in a non emergent patient...but for surgery MRI/CT might be needed to delineate length complications
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