Duplex ultrasound in aneurysm surveillance following endovascular aneurysm repair: a comparison with computed tomography aortography

Manning, Brian J.; O’Neill, Sean M.; Haider, S. N.; Colgan, Mary-Paula; Madhavan, Prakash; Moore, Dermot J.

doi:10.1016/j.jvs.2008.07.079

Cited by 91 publications

(69 citation statements)

References 17 publications

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“…Amongst potentially useful exams to identify an endoleak, CDUS (Color-Doppler Ultrasound) can be considered safe, inexpensive, repeatable and praised as a good choice. However, as it has been shown in our previous experience [20] and in many other studies [5][6][7]21], even this method is not reliable enough to identify endoleaks, with a high rate of false negatives and positives. This is due to the large amount of artifacts, such as the metal of the endoprosthesis, the shadow cone of possible calcification, the presence of low-flow endoleaks and of course intestinal gas or severe obesity (which would affect any type of ultrasound).…”

Section: Discussionmentioning

confidence: 76%

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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

David

Cantisani

Grazhdani³

et al. 2016

J Ultrasound

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Objective 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. Materials and methods 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. Results 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. Conclusions 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.Keywords Contrast-enhanced ultrasound Á CT Á Endoleak Riassunto Obiettivi dello studio Valutare l'accuratezza dell'ecocontrastografia (CEUS), confrontandola con angiografia con tomografia computerizzata (CT) per l'identificazione degli endoleak dopo trattamento di aneurisma dell'aorta addominale con endoprotesi. Materiali Da Settembre 2008 a Dicembre 2014, 181 pazienti consecutivi trattati con EVAR sono stati valutati con CEUS, CTA, ed anche con angiografia nei casi da ritrattare. Sono stati valutati: diametro della sacca, valutazione dell'integrita della sacca, identificazione e classificazione degli endoleaks. Sensibilità, specificità, accuratezza e valore predittivo negativo sono stati valutati per ogni modalita nell'identificazione degli endoleak. Risultati Quarantadue endoleak (23.2%; tipo II: 39 casi, tipo III: 3 casi) sono stati documentati. La Sensibilita della CEUS e della TC e stata rispettivamente del 97.6, 90.5%, mentre la specificita per entrambe e stata del 100%. In due casi la CEUS e stata in grado di classificare meglio gli endoleak rispetto alla CT. La sacca aneurismatica presentava alla CEUS e CDUS un diametro massimo compreso tra 39-82 mm, mentre alla TC tra 38 e 78 mm, senza significativa differenza tra le due metodiche. Conclusioni L'accuratezza della CEUS nell'identificazione degli endoleak e nella misurazione della sacca dopo EVAR, e simile alla TC con maggiore sensibilita ma analoga specificita. La CEUS e da considerarsi una modalita efficace per la sorveglianza a lungo termine degli EVAR in quanto capace di classificare correttamente gli endoleak senza esposizione a radiazioni ionizzanti.Parolechiave Contrast-enhanced ultrasound Á CT Á Endoleak

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Section: Discussionmentioning

confidence: 76%

“…Color Doppler ultrasound (CDUS) was initially the first choice due to its low cost, repeatability and the patient's compliance, but it has a variable sensitivity (between 43 and 97%) and it is operator and patient dependent [6,7].…”

Section: Introductionmentioning

confidence: 99%

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

David

Cantisani

Grazhdani³

et al. 2016

J Ultrasound

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“…US is an effective and cost-efficient imaging method for the screening and follow-up of infrarenal aortic aneurysms (18,19). However, it is not routinely used for follow-up of para-aortic RPF.…”

Section: Discussionmentioning

confidence: 99%

“…Since that time the quality of US scanners has improved dramatically, and modern techniques, such as tissue harmonic imaging (THI) and extended field-of-view US, have significant advantages for routine clinical diagnosis (15)(16)(17). Today, US has established itself as an effective and cost-efficient imaging method for the screening and follow-up of infrarenal aortic aneurysms (18,19). US, however, is not used routinely for RPF follow-up, nor has a systematic evaluation of modern ultrasonographic methods been available to date.…”

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confidence: 99%

The potential role of modern US in the follow-up of patients with retroperitoneal fibrosis

Kamper

Brandt

Ekamp³

et al. 2013

Diagn Interv Radiol

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ABDOMINAL IMAGINGORIGINAL ARTICLE PURPOSE We aimed to evaluate a standardized ultrasonography (US) algorithm for the visualization of pathologic para-aortic tissue in retroperitoneal fibrosis (RPF). MATERIALS AND METHODSThirty-five patients with lumbar RPF of typical extent, as determined by abdominal magnetic resonance imaging, were included. Examinations were conducted using standardized abdominal US with axial sections obtained at the levels of the renal arteries, aortic bifurcation, and both common iliac arteries. Imaging of each section was acquired with fundamental B-mode (US) and tissue harmonic imaging, respectively. In addition, we examined RPF visualized using extended fieldof-view US. RESULTSTissue harmonic imaging adequately visualized RPF of typical extent in 33 patients (94.2%). Excellent and good visualization with mild artifacts were achieved in 25 (71.4%) and six (17.1%) patients, respectively. When RPF spread along the iliac arteries, excellent visualization was achieved in 38.7% for the left side and 34.5% for the right side. There were significantly fewer diagnostic examinations for the right iliac (27.6%) than for the left one (9.7%) (P = 0.016). Overall, harmonic imaging achieved significantly better visualization than fundamental B-Mode (P < 0.001). CONCLUSIONWe described the first systematic evaluation of RPF visualization by modern US techniques. The best imaging quality was found in the typical RPF location, at the level of the aortic bifurcation. These results advocate for the presented US algorithm as an efficient follow-up alternative to cross-sectional imaging in RPF patients.

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“…A number of studies have indicated that CDU may be used for EVAR (Wolf et al, 2000;Manning et al, 2009). Non-contrast enhanced ultrasound correlates with CT angiography in determining change in AAA size over time, but has low sensitivity and positive predictive value in endoleak detection compared with conventional CT angiography (Manning et al, 2009;Elkouri et al, 2004;Raman et al, 2003).…”

Section: Contrast-enhanced Ultrasoundmentioning

confidence: 99%

Color-Doppler Ultrasonography in the Monitoring of Endovascular Abdominal Aortic Aneurysm Repair

Norberto¹,

Taylor²,

Vaquero³

2011

Diagnosis and Treatment of Abdominal and Thoracic Aortic Aneurysms Including the Ascending Aorta and the Aortic Arch

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Duplex ultrasound in aneurysm surveillance following endovascular aneurysm repair: a comparison with computed tomography aortography

Cited by 91 publications

References 17 publications

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

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

The potential role of modern US in the follow-up of patients with retroperitoneal fibrosis

Color-Doppler Ultrasonography in the Monitoring of Endovascular Abdominal Aortic Aneurysm Repair

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