| Summary: | Infectious aortitis (IA) is a rare and life-threatening cardiovascular disease. Early diagnosis and
timely intervention are crucial for reducing mortality associated with mycotic aortic aneurysms (MAAs);
however, early diagnosis is challenging due to the nonspecific symptoms. Some cases are diagnosed at an
advanced stage or after developing complications, such as rupture or aortic fistula. Current state-of-theart
imaging modalities—including computed tomography (CT), magnetic resonance imaging (MRI), and
18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT—can detect infected aneurysms in
clinically suspicious cases. MAA features on imaging include lobulated pseudoaneurysm, indistinct irregular
arterial wall, perianeurysmal gas, perianeurysmal edema, perianeurysmal soft tissue mass, aneurysmal
thrombosis, and high metabolic activity with increased uptake of FDG. Enlarged lymph nodes are often
found adjacent to the aneurysm, while iliopsoas abscess (IPA), spondylitis, and aortic fistulas are commonly
associated complications. After surgery or endovascular repair, radiological features—including ectopic
gas, peri-graft fluid, thickening of adjacent bowel, pseudoaneurysm formed at the graft anastomosis, and
increased uptake of FDG—may indicate an infection of aortic graft. This article provides an overview of the
clinical and imaging features of MAAs. Thus, familiarity with the imaging appearances of MAAs may assist
radiologists in the diagnosis and facilitation of timely treatment.
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