Abdominal Vasculature

Source: Khosa F, Krinsky G, Macari M, Yucel EK, Berland LL. Managing incidental findings on abdominal and pelvic CT and MRI, Part 2: white paper of the ACR Incidental Findings Committee II on vascular findings. J Am Coll Radiol. 2013;10(10):789-794. doi:10.1016/j.jacr.2013.05.021


Arterial Abnormalities

Penetrating Aortic UlcerAsymptomatic: annual follow-up
Symptomatic: “more frequent”
Iliac Artery Aneurysm<3.0 cm: no follow-up
3.0-3.5 cm: 6 month follow up
>3.5 cm: “expeditious follow-up”
Splenic Artery Aneurysm<2 cm: annual follow-up*
>2cm: surgical referral
Renal Artery Aneurysm<1.5 cm: 1-2 year follow up
>1.5 cm: surgical referral
Pancreaticoduodenal AneurysmAll should have surgical referral
Other AneurysmsIn general, if >2 cm surgical referral
Visceral dissectionAsymptomatic: follow-up imaging
*Consider risk factors for rupture: rapidly increasing size, occurrence in women of childbearing years, cirrhosis, symptomatic.
Society for Vascular Surgery guidelines. Source: Chaer RA, Abularrage CJ, Coleman DM, et al. The Society for Vascular Surgery clinical practice guidelines on the management of visceral aneurysms. J Vasc Surg. 2020;72(1S):3S-39S. doi:10.1016/j.jvs.2020.01.039

Venous Abnormalities

May Thurner CompressionNo swelling or VT: no follow-up
Nutcracker CompressionNo proteinuria, hypertension, hematuria: no follow-up
VTAcute: further investigation (modality varies)
Chronic: no further imaging
Dilated Pelvic Veins in FemalesConsider pelvic congestion syndrome
Asymptomatic: No follow-up
VT = venous thrombosis