Use of contrast-enhanced ultrasound in follow-up after endovascular aortic aneurysm repair.
OBJECTIVE
To investigate the use of contrast-enhanced ultrasound in the detection of endoleak after endovascular repair of abdominal aortic aneurysm.


METHODS
Eighteen patients underwent follow-up on 20 occasions after endovascular aortic aneurysm repair by arterial-phase contrast-enhanced spiral computed tomography (CT). All patients had unenhanced color Doppler ultrasound and Levovist-enhanced ultrasound on the same day. The ultrasound examinations were reported in a manner that was blind to the CT results. CT was regarded as the gold standard for the purposes of the study.


RESULTS
There were three endoleaks shown by CT. Unenhanced ultrasound detected only one endoleak (sensitivity, 33%). Levovist-enhanced ultrasound detected all three endoleaks (sensitivity, 100%). Levovist-enhanced ultrasound indicated an additional six endoleaks that were not confirmed by CT (specificity, 67%; positive predictive value, 33%). In one of these six cases, the aneurysm increased in size, which indicates a likelihood of endoleak. Two of the remaining false-positive results occurred in patients known to have a distal implantation leak at completion angiography.


CONCLUSIONS
In this small group of patients, contrast-enhanced ultrasound appears to be a reliable screening test for endoleak. The false-positive results with enhanced ultrasound may be due to the failure of CT to detect slow flow collateral pathways. Although the number of patients in this study is small, enhanced ultrasound may be more reliable than CT in detecting endoleak.
McWilliams
R G
RG
Department of Radiology, Royal Liverpool University Hospital, United Kingdom. peter@rluh.u-net.com
Martin
J
J
White
D
D
Gould
D A
DA
Harris
P L
PL
Fear
S C
SC
Brennan
J
J
Gilling-Smith
G L
GL
Bakran
A
A
Rowlands
P C
PC
D000368:Aged; D000792:Angiography; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides / Q000008:administration & dosage; D019106:Postoperative Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology; D011237:Predictive Value of Tests; D011475:Prosthesis Failure; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color / Q000379:methods*
D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508