Aortic sonography uses B-mode and Doppler ultrasound to evaluate the thoracic and abdominal aorta for aneurysmal disease, dissection, and atherosclerosis. Abdominal aortic aneurysm (AAA) screening is a level A USPSTF recommendation for men aged 65–75 with smoking history, and ultrasound is the preferred screening modality.
Sonographers measure maximum aortic diameter from outer wall to outer wall at the infrarenal segment, iliac arteries, and suprarenal aorta. An aortic diameter of 3.0 cm or greater defines aneurysm; dimensions of 5.5 cm in men or 5.0 cm in women typically meet thresholds for surgical or endovascular repair consideration. Post-EVAR surveillance includes identification of endoleaks (type I–V), stent graft morphology, and sac diameter changes. Aortic Doppler assesses for occlusive disease in patients with claudication.
Aortic sonography falls under both the ARDMS Abdomen (AB) and Vascular Technology (VT) specialties depending on the scope of examination. Sonographers perform aortic studies in vascular surgery practices, hospital radiology and vascular labs, community AAA screening programs, and post-EVAR surveillance clinics. Technical challenges include bowel gas interference and patient obesity, which may require lateral decubitus positioning and harmonic imaging optimization.