Abbas, A

Ghosh, J

Hansrani, V

McCollum, C

Mccollum, Charles

Sedgwick, N

Introduction:CT angiography (CTA) for post-EVAR surveillance involves irradiation and nephrotoxic X-ray contrastagents. 3D CEUS is a novel imaging technique that may be more sensitive to blood flow detection than CTAor 2D contrast enhanced ultrasound (2D CEUS). 3D CEUS utilises positional information from magnetic fieldemitters to assemble all ultrasound reflections into a high definition image. We compared 3D CEUS with CTAfor the detection of endoleak and aneurysm expansion following EVAR.Methods:3D CEUS (Curefab), 2D CEUS (Philips IU22) and CTA were compared in 30-paired images from 23 patients.Sensitivity, specificity, positive and negative predictive value was calculated for 3D CEUS with CT as the‘gold standard’. Pearson correlation was used to compare aneurysm sac diameter. Data were analysedusing SPSS version 19.0.Results:30 paired 3D CEUS and CTA images were analysed from 23 patients. Endoleaks were detected in 17images with CTA, 18 on 2D CEUS and 18 on 3D CEUS. The sensitivity, specificity, positive and negativepredictive values of 3D CEUS to detect endoleak were 100%, 92%, 94% and 100% respectively. There wasexcellent correlation (r =0.935; p _ 0.0001) between CT and 3D CEUS for AAA sac diameter. Only 3D CEUSbuilds an image of the route the endoleak takes and reliably shows the exit and entrance point in sac,detecting the inflow artery in all 18 scans with endoleak. 2D CEUS detected the inflow in 16 (88.8%) andCTA on 12 (66.6%) images.There was one ‘false +ve’ result on 3D and 2D CEUS, which is possibly a ‘true +ve’ as this patient had anexpanding AAA with oscillating thrombus in the sac, implying an intermittent endoleak which wasthrombosed at the time of imaging. This endoleak was not seen on subsequent angiography but the clinicaldecision was to treat.Conclusion:3D CEUS may be more sensitive to detect the source of an endoleak following EVAR than either 2D CEUSor CTA

3D Contrast Enhanced Ultrasound (3D CEUS) for Detecting Endoleak Following Endovascular

Abstract

Similar works

Full text

Available Versions

The University of Manchester - Institutional Repository