Anatomia aortei abdominale

Diametru n jur de 20 mm
Traiect rectiliniu, poate fi sinuos la vrstnici
Ramuri
Parietale a. diafragmatice inf., art. lombare (4 perechi)
Ramuri viscerale
-tr. celiac - origine pe faa ant a aortei, direcie spre nainte,
d art. gastric stg, a hepatic comun, a splenic
- art. mezenteric superioar de pe faa ant a aortei, la cca.
10 mm sub tr. celiac; direcie n jos
-A renale - de pe feele laterale sub a. mezenteric sup
-A- testiculare / ovariene pe faa ant, ntre a renale i mez inf
-A. mezenteric inferioar faa ant. a aortei la 5 cm nainte de
bifurcaie
-- a iliace

Tehnica examinrii
Pregtirea pacientului
Sondele folosite
Poziia pacientului

Ecografia normala - aorta abdominal

Tub cu peretei fini, limen anecogen
Calibrul scade spre bifurcatie
Calibrul se masoara pe sectiune transversala atentie sa nu inclinam
sonda - supraevaluare

Ecografia normala - trunchiul celiac

Primul ram important subdiafragmatic
Diametru 6 13 mm
Ramuri
- a hepatica comuna directie spre dr
- a. splenic diametru 4 8 mm, pe fata craniala a pancreasului,
deasupra venei splenice. In hil da 6 30 ramuri
- artera gastrica stga.

Se vizualizeaza bine pe sectiune sagitala si longitudinala

Variante anatomice
Doppler
- flux spre sonda
-Curba monofazica
-Viteza sistolica 90 -130 cm/s

Fig. 7.9 a The celiac trunk

and superior mesenteric
artery in sagittal section, and
b the celiac trunk as it
branches into the common
hepatic artery and splenic
artery in a transverse
sectional plane. c A colorcoded display of the flow in
the celiac trunk and the
proximal segments of the com
mon hepatic artery and
splenic artery. d A frequency
spectrum from the distal
section of the celiac trunk
proximal to the origin of the
common hepatic artery and
the splenic artery, with a
maximum systolic flow
velocity of 166 cm/s and a
Pourcelot resistance index of
0.74 (AO aorta, SMA superior
mesenteric artery)

Fig. 7.9
a The celiac trunk and
superior mesenteric artery in sagittal
section, and b the celiac trunk as it
branches into the common hepatic
artery and splenic artery in a trans
verse sectional plane. c A color-coded
display of the flow in the celiac trunk
and the proximal segments of the
common hepatic artery and splenic
artery. d A frequency spectrum from
the distal section of the celiac trunk
proximal to the origin of the common
hepatic artery and the splenic artery,
with a maximum systolic flow
velocity of 166 cm/s and a Pourcelot
resistance index of 0.74 (AO aorta,
SMA superior mesenteric artery)

,A color flow duplex sonogram of the

splenic artery and a frequency
spectrum obtained from the distal
vascular segment, approximately 6
cm after its origin. A color change in
the sample volume can be seen,
which is due to aliasing, caused by an
angle-related higher frequency shift
during the color flow Doppler mode.
There is no pathological flow
acceleration. Maximum systolic flow
velocity 92 cm/s, end-diastolic flow
velocity 37 cm/s, Pourcelot resistance
index 0.60

Fig 7.12 a Sonogram of the origin of the left gastric artery (") from the
celiac trunk (T) in transverse section (AO=abdominal aorta,
SMA=superior mesenteric artery). b Subxiphoid transverse section,
showing blood flow in the abdominal aorta (cross-section, blue color
coding), with the origin of the celiac trunk proceeding

Ecografia normala - a. mezenterica sup.

Origine pe fata ventrala a aortei, la 5 20 mm sub tr. celiac
Post. de pancreas
Traseu paralel cu peretele aortic
Pe sectiune transversala imagine rotunda ant. de aorta; raportul cu
vena renala stga
Diametru in segmentul proximal 8 14 mm; variaza cu digestia.
Se vizualizeaza bine pe sectiune sagitala si longitudinala
Examen Doppler viteza variaza cu fazele digestiei
- a jeun = flux trifazic, V sist 90 -150 cm/s
- post prandial creste diametrul, creste volumul de singe
circulant, apare flux tip rezistenta scazuta

Fig.7.13 a Sagitta) section through the

abdominal aorta, with the ventral origin of
the superior mesenteric artery shown in
the color-coded image. Aliasing is seen
near the origin of the superior mesenteric
artery. It is due to a steeper incident angle
of the color flow Doppler beam. The flow
direction is directed toward the
transducer. Maximum systolic flow
velocity 138 cm/s, end-diastolic flow
velocity 13 cm/s, mean flow velocity 41
cm/s, Pourcelot resistance index 0.91,
Gosling pulsatility index 3.03. b In Mmode, the walls of the aorta and the
superior mesenteric artery are seen, with
pulsatile and respiration-dependent
movements. The diameter of the superior
mesenteric artery is 7.4 mm

Doppler normal pe aorta abdominal

Deasupra artrerelore renale poate s aib aspect de flux cu
rezisteb sczut
Sub arterele renale flux trifazic , rezisten crescut
Vitezele normale intre 70 -140 cm/s

Doppler normal pe arterele viscerale

Flux tip rezistene sczute
Vitezele in arterele viscerale sunt influentate de :
Miscarile respiratorii cresc in inspir, cresc la Valsalva (Kamps et
al. 1992)
Fazele digestiei postprandial cresc V sistolica, V diastolica si
calibrul art mezenterice sup si a tr. celiac
Agenti farmacologici raspuns similar la glucagon, colecistokinina

Doppler color
traseul arterelor viscerale rareori rectiliniu
greu de urmarit pe tot traseul
schimbarile de directie alternanta de culoare
dificultati legate de miscarile respiratorii si ale anselor intestinale

Doppler energie
util pentru teritoriile cu flux lent (in parenhim, tumori)
avantajos la vasele cu schiumbari dese de directie
sensibil la miscare
nu face distinctia intre artere si vene

Patologia
Stenoza, ocluzia
Anevrismul
Disecia