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

作者：Guertler Verena M; Sommer Wieland H; Meimarakis Georgios; Kopp Reinhard; Weidenhagen Rolf; Reiser Maximilian F; Clevert Dirk Andre^*

来源：Journal of Vascular Surgery, 2013, 58(2): 340-345.

DOI：10.1016/j.jvs.2013.01.039

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 kappa 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.

• 出版日期2013-8