A comparison between contrast-enhanced ultrasound imaging and multislice computed tomography in detecting and classifying endoleaks in the follow-up after endovascular aneurysm repair.

Abstract

BACKGROUND:

This study compared contrast-enhanced ultrasound (CEUS) imaging and multislice computed tomography (MS-CT) angiography in detecting and classifying endoleaks in the follow-up of patients after endovascular aneurysm repair (EVAR).

METHODS:

This retrospective study consisted of 171 patients with CEUS imaging and MS-CT angiography follow-up examinations after EVAR. During follow-up, 489 CEUS and 421 MS-CT examinations were assessed. B-scan, color Doppler, and CEUS imaging were performed in all patients. MS-CT was performed with a 16-slice up to 128-slice scanner.

RESULTS:

From the 132 patients in our cohort, we obtained 200 contemporary imaging examination pairs. MS-CT was used as the preferred examination in determining the presence of an endoleak. The true-positive rate for the detection of endoleaks with CEUS imaging was 42% (84 of 200), the false-positive rate was 4% (8 of 200), the true-negative rate was 52% (105 of 200), and the false-negative rate was 2% (3 of 200). The sensitivity of CEUS imaging was therefore 97%, and the specificity was 93%. The McNemar test value was 0.227, and the κ coefficient was 0.889.

CONCLUSIONS:

CEUS imaging appears to be as good as MS-CT angiography in the detection of endoleaks in the follow-up after EVAR, with the added advantages of no radiation dose and no nephrotoxicity of the contrast agents. A switch of the preferred examination from MS-CT to CEUS imaging should be considered.

• Authors: Verena M Gürtler, Wieland H Sommer, Georgios Meimarakis, Reinhard Kopp, Rolf Weidenhagen, Maximilian F Reiser, Dirk-André Clevert
• Journal: Journal of vascular surgery (J Vasc Surg) Vol. 58 Issue 2 Pg. 340-5 (Aug 2013) ISSN: 1097-6809 [Electronic] United States
• PMID: 23591188 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2013 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

Chemical References

• Contrast Media

Topics

• Adult
• Aged
• Aged, 80 and over
• Aortic Aneurysm, Abdominal (surgery)
• Aortography (methods)
• Blood Vessel Prosthesis Implantation (adverse effects)
• Contrast Media
• Endoleak (diagnostic imaging, etiology)
• Endovascular Procedures (adverse effects)
• False Negative Reactions
• False Positive Reactions
• Female
• Humans
• Male
• Middle Aged
• Multidetector Computed Tomography
• Predictive Value of Tests
• Retrospective Studies
• Time Factors
• Treatment Outcome
• Ultrasonography, Doppler, Color