No Concern for AAA Based on This Imaging
The abdominal ultrasound shows normal aortic dimensions with no evidence of abdominal aortic aneurysm. The mid-aortic measurement of 2.3 cm is well within normal limits and does not meet diagnostic criteria for AAA.
Interpretation of Aortic Measurements
The reported measurements (proximal 1.8 cm, mid 2.3 cm, distal 1.8 cm) are all normal and fall well below the 3.0 cm threshold that defines AAA 1, 2, 3.
An AAA is defined as infrarenal aortic diameter ≥3.0 cm or >1.5 times the adjacent normal segment 3. This patient's measurements do not approach either criterion.
Normal descending/abdominal aorta dimensions range from 1.0-1.6 cm/m² body surface area, with upper limits typically <2.8 cm 1.
Clinical Significance of 2.3 cm Measurement
A 2.3 cm mid-aortic diameter represents a normal caliber vessel, not even reaching "ectatic" classification (which begins at 2.6 cm) 4.
Some screening programs consider aortas of 2.6-2.9 cm as ectatic and recommend surveillance, but this patient's measurements are below even that threshold 4.
The ultrasound report explicitly states the aorta is patent without noting any aneurysmal dilation, which would be prominently featured if present.
No Surveillance Required
No follow-up imaging for aortic surveillance is indicated based on these normal findings 5, 3.
Surveillance protocols only apply when AAA is present (≥3.0 cm), with intervals determined by size: every 3 years for 3.0-3.9 cm, annually for 4.0-4.9 cm, and every 6 months for ≥5.0 cm 5, 3.
Ultrasound is the appropriate modality for AAA screening and surveillance when indicated, with sensitivity and specificity approaching 100% 1, 2.
Other Imaging Findings Requiring Attention
The hepatic complicated cyst/mass (3.0 x 2.5 x 2.7 cm) noted as "unchanged" requires appropriate follow-up based on prior imaging history and clinical context, though this is unrelated to aortic pathology.
Bilateral pleural effusions and left renal cysts (up to 4.1 cm) should be addressed according to their clinical significance, but neither relates to AAA concerns.
Common Pitfall to Avoid
Do not confuse normal aortic caliber with aneurysmal disease—the 2.3 cm measurement is approximately 75% of the 3.0 cm diagnostic threshold for AAA 1, 3.
Ensure measurements are taken perpendicular to the vessel's long axis to avoid overestimation in tortuous vessels, though this is not a concern with clearly normal dimensions 2, 3.