Dear Ultrasound Insider,
Abdominal aortic aneurysms (AAA) are often asymptomatic until they rupture, usually a fatal event unless surgery is performed quickly.
But while support for ultrasound screening for AAA is on the rise, concern is also growing that screening and new surgical techniques could combine to produce more perioperative deaths among patients who had a low risk of rupture, according to Thomas Jefferson University's Dr. Christopher Merritt.
The risk of elective surgery must be balanced against the rupture risk of an untreated aneurysm, the danger of which is directly related to aneurysm size, Merritt said. He discussed the issues surrounding screening ultrasound for AAA during a talk at the Leading Edge in Diagnostic Ultrasound conference in Atlantic City.
As an Ultrasound Insider subscriber, you have access to this story before it is published for the rest of our AuntMinnie.com members. To read more about this issue's featured article, just point your browser here.
Do you have an idea for a topic you'd like to see covered, or article you'd like to submit? As always, please feel free to drop me a line.
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
