An abdominal aortic aneurysm is often discovered incidentally during an imaging study done for other reasons.
Sometimes it can be felt as a pulsatile mass during a routine physical exam by your doctor.
If your doctor thinks you might have an aortic aneurysm, you will likely have a medical history and physical exam.
You will then have further imaging tests to locate the aneurysm and estimate its size:
Abdominal Ultrasound
Abdominal Ultrasound: It is simple, fast, non-invasive and accurate in the diagnosis of an abdominal aortic aneurysm.
It can be used for screening or surveillance of a known aortic aneurysm.
Men and women after the age of 55, particuarly smokers (aor ex-smokers) and those with a family history of aneurysm should get an abdominal ultrasound for screening and early diagnosis.
Computed Tomography Angiography (CTA
Computed Tomography Angiography (CTA): It is the most accurate study for the diagnosis of an abdominal aortic aneurysm, at the cost though of the need for radiation and intravenous dye (iodinated contrast) that may be harmful for the kidneys, especially in patients with impaired renal function.
Your vascular surgeon will request this study to gather detailed information on the specific anatomy of the aneurysm and its relation to the renal or other splanchnic arteries.
This information is particularly important for preoperative planning.
Magnetic Resonance Angiography (MRA)
Magnetic Resonance Angiography (MRA): It can be as accurate as the CTA, doesn't require radiation and if intravenous contrast is used (gadolinium) it is less harmful for the kidneys.
Drawbacks are that it may be time consuming, it is expensive and it may be contraindicated in patients with claustrophobia or metallic implants.
Traditional Angiography
Traditional Angiography: It is an invasive imaging study done in a surgical environment as it requires arterial access through a groin puncture.
It requires radiation and intravenous contrast and it may be used to assist your vascular surgeon's operative plan.
In contemporary practice, it is not routinely recommended for diagnosis.
It will eventually be used as part of your treatment if an endovascular repair has been decided.