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Review
. 2025 Mar 27;17(3):e81321.
doi: 10.7759/cureus.81321. eCollection 2025 Mar.

Advances in Imaging and Diagnosis of Abdominal Aortic Aneurysm: A Shift in Clinical Practice

Abubakar I Sidik  1 , Malik K Al-Ariki  2 , Abdulmajid Ilyas Shafii  3 , Md Limon Hossain  4 , Farjana Najneen  3 , Gulten Ak  3 , Derrar Ahlam  3 , Abdoli Shakiba  3 , Debraj Ghosh  3 , Mst Asia Ajgar Bithi  3 , Mussalim I Kairatuly  3
Affiliations
Review

Advances in Imaging and Diagnosis of Abdominal Aortic Aneurysm: A Shift in Clinical Practice

Abubakar I Sidik et al. Cureus. .

Abstract

Abdominal aortic aneurysm (AAA) is a potentially life-threatening vascular condition, with rupture carrying a high mortality risk. Advances in imaging technologies have significantly improved the detection, risk stratification, and management of AAA, necessitating periodic updates to international clinical guidelines. This review examines recent advancements in AAA imaging modalities, their role in diagnosis and risk assessment, and evolving screening strategies in response to changing epidemiological trends. A systematic literature search was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, identifying key studies on diagnostic imaging techniques such as ultrasonography (US), computed tomography angiography (CTA), magnetic resonance angiography (MRA), intravascular US (IVUS), positron emission tomography-computed tomography (PET-CT), and artificial intelligence (AI)-driven imaging. US remains the preferred screening tool due to its cost-effectiveness, while CTA is the gold standard for preoperative planning. MRA is an alternative for patients with renal impairment, and emerging technologies such as AI-based imaging, IVUS, and PET-CT enhance risk prediction and surgical decision-making. Declining AAA prevalence, attributed to reduced smoking rates and improved cardiovascular risk management, has led to a shift from population-wide screening to targeted screening based on individual risk factors. Additionally, the standardization of imaging protocols and caliper placement techniques is crucial for accurate measurements and consistent clinical decision-making. As imaging technology continues to evolve, integrating AI, genetic markers, and biomarkers into screening and diagnostic protocols may enable more precise and personalized AAA management. Future research should focus on refining imaging-based risk stratification models to optimize screening and treatment strategies.

Keywords: abdominal aortic aneurysm; artificial intelligence; computed tomography angiography; imaging; risk stratification; screening programs; ultrasonography.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. PRISMA flow diagram detailing steps in the identification and screening of sources
PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analysis
Figure 2
Figure 2. AAA with a narrowed lumen due to large thrombotic mass partially occluding it
AAA: abdominal aortic aneurysm Authors' original image
Figure 3
Figure 3. Caliper placement for measurement of aortic diameter
OTO: outer to outer, ITI: inner to inner, LELE: leading edge to leading edge Authors' original image
See this image and copyright information in PMC

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