title: 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.
abstract: 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.
  
  
  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.
authors.affiliation: Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Via Consolare Valeria 1, 98124 Messina, Italy.
authors.forename: E
authors.initials: E
authors.lastname: David
authors.affiliation: Department of Radiology, Oncology, and Anatomo Pathology, "Sapienza" University of Rome, Rome, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Cantisani
authors.affiliation: Associazione dei Cavalieri Italiani Sovrano Militare Ordine di Malta; Poliambulatorio Roma, Eur Piazza Guglielmo Marconi 12, 00144 Rome, Italy.
authors.forename: H
authors.initials: H
authors.lastname: Grazhdani
authors.affiliation: Department of Surgery Pietro Valdoni, Sapienza University, Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Di Marzo
authors.affiliation: Department of Surgery Pietro Valdoni, Sapienza University, Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Venturini
authors.affiliation: Department of Radiology, Oncology, and Anatomo Pathology, "Sapienza" University of Rome, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Fanelli
authors.affiliation: Department of Radiology, Oncology, and Anatomo Pathology, "Sapienza" University of Rome, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Di Segni
authors.affiliation: Department of Radiology, Oncology, and Anatomo Pathology, "Sapienza" University of Rome, Rome, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Di Leo
authors.affiliation: Department of Medicine and Health Sciences, University of Molise, Contrada Tappino, 86100 Campobasso, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Brunese
authors.affiliation: University Hospital of Pavia, Viale Camillo Golgi 19, 27100 Pavia, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Calliada
authors.affiliation: Department of Radiology, Oncology, and Anatomo Pathology, "Sapienza" University of Rome, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Ciccariello
authors.affiliation: Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Via Consolare Valeria 1, 98124 Messina, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Bottari
authors.affiliation: Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Via Consolare Valeria 1, 98124 Messina, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Ascenti
authors.affiliation: Department of Radiology, Oncology, and Anatomo Pathology, "Sapienza" University of Rome, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: D'Ambrosio
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D000072226:Computed Tomography Angiography; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011475:Prosthesis Failure; D012680:Sensitivity and Specificity; D014463:Ultrasonography
chemical_list: D003287:Contrast Media
keywords: CT; Contrast-enhanced ultrasound; Endoleak