ACR Appropriateness Criteria® Pulsatile Abdominal Mass Suspected Abdominal Aortic Aneurysm

Stephen P. Reis*, Bill S. Majdalany, Ali F. AbuRahma, Jeremy D. Collins, Christopher J. Francois, Suvranu Ganguli, Heather L. Gornik, A. Tuba Kendi, Minhajuddin S. Khaja, Patrick T. Norton, Patrick D. Sutphin, Frank J. Rybicki, Sanjeeva P. Kalva, Expert Panel on Vascular Imaging:

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Clinical palpation of a pulsating abdominal mass alerts the clinician to the presence of a possible abdominal aortic aneurysm (AAA). Imaging studies are important in diagnosing and categorizing the extent of the aneurysm and may aid in treatment planning. The consensus of the literature supports the use of ultrasound as the initial screening test in patients with suspected AAA. Population-based ultrasound screening studies have been recommended and have proved effective for male patients > 65 years of age. For diagnosis and pre-intervention evaluation, either multidetector CT or CT angiography is the optimal choice for detailed characterization of the aneurysm. MR angiography may be substituted if CT cannot be performed (for example, because the patient is allergic to iodinated contrast material). Invasive angiography has little role in the diagnosis of AAA and PET and CT remain experimental in patients with suspected aneurysms. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

Original languageEnglish (US)
Pages (from-to)S258-S265
JournalJournal of the American College of Radiology
Issue number5
StatePublished - May 2017


  • AAA
  • AUC
  • Appropriate Use Criteria
  • Appropriateness Criteria
  • CTA
  • MRA
  • abdominal aortic aneurysm
  • ultrasound

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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