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Normal AAA Screening Ultrasound Report Template
Normal abdominal aortic aneurysm screening ultrasound report template: maximal outer-to-outer AP and transverse aortic diameters at the suprarenal, infrarenal and bifurcation levels, common iliac arteries, no aneurysm, with notes on the 3 cm threshold, surveillance intervals and the limited-study wording.
EXAMINATION: Ultrasound of the abdominal aorta, screening for abdominal aortic aneurysm. CLINICAL HISTORY: [indication, e.g. “Abdominal aortic aneurysm screening, male age 65-75 with a smoking history”] COMPARISON: None available. TECHNIQUE: Grayscale and color Doppler imaging of the abdominal aorta from the diaphragmatic hiatus to the aortic bifurcation in the transverse and longitudinal planes, with the common iliac arteries at their origins. Diameters were measured outer wall to outer wall, perpendicular to the long axis. FINDINGS: Visualization: The abdominal aorta is well visualized throughout its length [despite / without] bowel gas. Aortic diameters (outer to outer): Proximal (suprarenal) aorta: [x] cm AP, [x] cm transverse. Mid (infrarenal) aorta: [x] cm AP, [x] cm transverse. Distal aorta (above the bifurcation): [x] cm AP, [x] cm transverse. Maximal aortic diameter: [x] cm, infrarenal. Aortic wall and lumen: Normal caliber throughout, tapering normally to the bifurcation. No focal dilatation, saccular outpouching or intramural thrombus. [Mild atherosclerotic wall calcification.] No dissection flap. Common iliac arteries: Right [x] cm and left [x] cm at the origins. No iliac aneurysm. Flow: Normal antegrade color flow throughout the imaged aorta. Other: No periaortic fluid or mass. [The visualized inferior vena cava is unremarkable.] IMPRESSION: 1. Normal caliber abdominal aorta, maximal diameter [x] cm. No abdominal aortic aneurysm. 2. No further screening is indicated for a negative screening examination in this age group.
Dictation notes
- The aneurysm threshold is 3.0 cm (or 1.5 times the adjacent normal segment) measured outer wall to outer wall in the anteroposterior plane perpendicular to the lumen; an oblique or inner-to-inner measurement under-reads the diameter and is the commonest reason a 3.2 cm aorta is called normal.
- A screening study that is complete and negative needs no repeat in the USPSTF population; an ectatic aorta of 2.5-2.9 cm is reported with a 5-10 year recheck, and aneurysms are followed at 3 years (3.0-3.9 cm), 1 year (4.0-4.9 cm), 6 months (5.0-5.4 cm) and referred to vascular surgery at 5.5 cm, rapid growth, or symptoms.
- If bowel gas or body habitus hides a segment, say which segment and that the study is limited; a non-visualized infrarenal aorta is a non-diagnostic screen and gets a repeat or CT, not a “normal visualized aorta”.
- Report the common iliac arteries at the bifurcation: an iliac aneurysm (1.5 cm or more) is found with or without an aortic aneurysm and has its own repair threshold around 3.0-3.5 cm.
- A tender aorta, periaortic hypoechoic fluid or a retroperitoneal collection on a screening scan is a rupture until proven otherwise — the report is a phone call, not a surveillance interval.
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