What is the role of contrast-enhanced ultrasound in the evaluation of the endoleak of aortic endoprostheses? A comparison between CEUS and CT on a widespread scale

• DOI: 10.1007/s40477-016-0222-5
• Publication Date: 2016-11-23T00:53:36Z
• Authors: E. David; V. Cantisani; H. Grazhdani; L. Di Marzo; L. Venturini; F. Fanelli; M. Di Segni; N. Di Leo; L. Brunese; F. Calliada; M. Ciccariello; A. Bottari; G. Ascenti; F. D’Ambrosio
• Keywords: Male; Endoleak; Computed Tomography Angiography; 610; Contrast Media; Sensitivity and Specificity; Follow-Up Studie; Blood Vessel Prosthesis Implantation; 03 medical and health sciences; 0302 clinical medicine; Nuclear Medicine and Imaging; Internal Medicine; Humans; Abdominal; Contrast-enhanced ultrasound; CT; Endoleak; Aged; Angiography, Digital Subtraction; Aortic Aneurysm, Abdominal; Blood Vessel Prosthesis Implantation; Female; Follow-Up Studies; Humans; Male; Prosthesis Failure; Sensitivity and Specificity; Blood Vessel Prosthesis; Computed Tomography Angiography; Contrast Media; Ultrasonography; Internal Medicine; Radiology, Nuclear Medicine and Imaging; Aged; Ultrasonography; contrast-enhanced ultrasound; CT; endoleak; internal medicine; radiology, nuclear medicine and imaging; Angiography; Angiography, Digital Subtraction; Aortic Aneurysm; Blood Vessel Prosthesis; Prosthesis Failure; Blood Vessel Prosthesi; Female; Radiology; Contrast-enhanced ultrasound; CT; Digital Subtraction; Human; Aortic Aneurysm, Abdominal; Follow-Up Studies

To evaluate the accuracy of contrast-enhanced ultrasound (CEUS) in comparison to CT angiography (CTA) to identify and classify endoleaks following abdominal aortic aneurism repair with endoprosthesis.A retrospective analysis of 181 patients treated with EVAR, from September 2009 to September 2014, was performed. Patients were evaluated with CEUS, CTA and angiography in the cases requiring treatment. Sac diameter, sac integrity, identification and classification of endoleaks were taken into consideration. Sensitivity, specificity, accuracy and negative predictive values were considered for each modality of endoleak identification.Forty-two endoleaks (23.2%; type II: 39 cases, type III: 3 cases) were documented. Sensitivity and specificity of CEUS and CT were, respectively, 97.6 and 90.5, 100 and 100%. In two cases, CEUS was able to better classify endoleaks compared to CT.CEUS accuracy to identify endoleaks following EVAR is similar to CT. CEUS should be considered as an effective modality for the long-term surveillance of EVAR because of its capability to correctly classify endoleaks with no ionizing radiation exposure.