title: A comparison between contrast-enhanced ultrasound imaging and multislice computed tomography in detecting and classifying endoleaks in the follow-up after endovascular aneurysm repair.
abstract: 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 κ 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.
authors.affiliation: Department for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany.
authors.forename: Verena M
authors.initials: VM
authors.lastname: Gürtler
authors.forename: Wieland H
authors.initials: WH
authors.lastname: Sommer
authors.forename: Georgios
authors.initials: G
authors.lastname: Meimarakis
authors.forename: Reinhard
authors.initials: R
authors.lastname: Kopp
authors.forename: Rolf
authors.initials: R
authors.lastname: Weidenhagen
authors.forename: Maximilian F
authors.initials: MF
authors.lastname: Reiser
authors.forename: Dirk-André
authors.initials: DA
authors.lastname: Clevert
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / 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*; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color
chemical_list: D003287:Contrast Media