Study of endoleaks after endovascular repair by using MDCTA.
OBJECTIVE
Our purpose was to investigate the multi-detector-row CT angiography (MDCTA) application in endoleak detection.


METHODS
Fifty-nine patients that underwent endovascular aneurysm repair (EVAR) of an infrarenal abdominal aortic aneurysm with endoluminal stent graft were retrospectively studied. MDCTA scans were obtained after administration of 110-130 mL of contrast material using a 4-6 mL/sec flow rate. We made unenhanced, arterial (15-20 sec) and delayed (100 sec) acquisitions. For each patient four MDCTA datasets (pre-EVAR, 1, 6, and 12 months follow-up) were obtained. Each examination was studied by two observers. Kappa value was calculated in order to evaluate inter-observer agreement.


RESULTS
Twenty-one endoleaks were detected in eighteen patients. Fifteen and eighteen endoleaks were detected by using biphasic arterial CT and biphasic delayed CT respectively (sensitivity of 71.4% and 85.7% respectively). We observed a positive correlation between the presence of endoleak and the increasement in aneurysm size. Interobserver agreement was 88.1% and kappa value was 0.685.


CONCLUSIONS
Biphasic CT for endoleak detection is significantly superior to arterial and delayed phases respectively. We observed a good interobserver agreement.
Department of Science of the Images, A.O.U. di Cagliari, Cagliari, Italy. lucasaba@tiscali.it
L
L
Saba
R
R
Sanfilippo
L
L
Pascalis
R
R
Montisci
G
G
Mallarini
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D003287:Contrast Media; D057867:Endoleak / Q000000981:diagnostic imaging* / Q000209:etiology; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D003287:Contrast Media