Detection and Characterization of Endoleaks Following Endovascular Treatment of Abdominal Aortic Aneurysms using Contrast Harmonic Imaging (CHI) with Quantitative Perfusion Analysis (TIC) Compared to CT Angiography (CTA)

Jung, E. M. and Rennert, J. and Fellner, C. and Uller, W. and Jung, W. and Schreyer, A. and Heiss, P. and Hoffstetter, P. and Feuerbach, S. and Kasparzk, P. and Zorger, N. and Pfister, K. (2010) Detection and Characterization of Endoleaks Following Endovascular Treatment of Abdominal Aortic Aneurysms using Contrast Harmonic Imaging (CHI) with Quantitative Perfusion Analysis (TIC) Compared to CT Angiography (CTA). ULTRASCHALL IN DER MEDIZIN, 31 (6). pp. 564-570. ISSN 0172-4614

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Abstract

Purpose: To show the feasibility of the detection of endoleaks following endovascular treatment of aortic aneurysms using contrast harmonic imaging (CHI) in comparison to computed tomography angiography (CTA). Materials and Methods: 51 patients with suspected endoleaks, who underwent previous endovascular treatment for abdominal aortic aneurysm, were examined using CTA and vascular ultrasound. Biphasic CTA in all cases and digital subtraction angiography (DSA) in 8 patients were evaluated by two radiologists in consensus and served as the standard of reference. Ultrasound was performed by an experienced examiner with a multi-frequency linear transducer (2 - MHz) using CHI following bolus injection of 2.4 ml of SonoVue (R) IV (maximum 5ml). All images were evaluated by two observers in consensus regarding the reperfusion of the abdominal aneurysm using time intensity curve (TIC) analysis. Results: In 30 of 51 patients, endoleaks were detected concordantly in CHI and CTA. In 20 of 51 patients, no endoleak was found in CHI and CTA/DSA. In one patient, a type II endoleak could initially only be detected in CHI and was later confirmed in follow-up examinations by CTA (sens. 99%, spec. 93%, NPV 99%, PPV 95%). TIC analysis allowed evaluation of the perfusion dynamics of endoleaks in all patients. Significant differences were found (p < 0.05, Mann Whitney U Test) regarding the perfusion within the aneurysm when an endoleak was present (10.39 +/- 4.29 dB) or not present (6.42 +/- 2.86 dB). Conclusion: CHI with perfusion analysis allows definite detection of endoleaks, especially if contraindications for CTA are present. CHI presents an alternative for follow-up monitoring.

Item Type: Article
Uncontrolled Keywords: COLOR DUPLEX ULTRASOUND; CLINICAL-PRACTICE RECOMMENDATIONS; ENHANCED-ULTRASOUND; COMPUTED-TOMOGRAPHY; II ENDOLEAKS; CANINE MODEL; RISK-FACTORS; UPDATE 2008; REPAIR; SURVEILLANCE; aorta; ultrasound; aneurysm
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Abteilung für Gefäßchirurgie
Medicine > Lehrstuhl für Röntgendiagnostik
Depositing User: Petra Gürster
Date Deposited: 21 Apr 2020 10:19
Last Modified: 21 Apr 2020 10:19
URI: https://pred.uni-regensburg.de/id/eprint/23840

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