J Endovasc Ther. 2003 Apr;10(2):208-17. Contrast-eJ Endovasc Ther. 2003 Apr;10(2):208-17. Contrast-enhanced ultrasound imaging for aortic stent-graft surveillance. Giannoni MF, Palombo G, Sbarigia E, Speziale F, Zaccaria A, Fiorani P. Department of Vascular Surgery, University of Rome La Sapienza, Rome, Italy. mariafabrizia.giannoni@uniroma1.it PURPOSE: To compare unenhanced and enhanced ultrasound imaging to computed tomographic angiography (CTA) or magnetic resonance angiography (MRA) for surveillance of aortic endografts. METHODS: Thirty consecutive patients (29 men; mean age 69 years, range 50-82) who underwent endovascular aortic aneurysm repair agreed to participate in a follow-up program. Patients underwent CTA (26/30) or MRA (4/30), plain abdominal radiography, and unenhanced and enhanced ultrasound examinations at 3, 12, and 24 months to evaluate aneurysm diameter, endoleaks, and graft patency. The accuracy of ultrasound was compared with CTA or MRA as the reference standards. RESULTS: Twenty-six patients reached the 24-month assessment (mean follow-up 30 months, range 6-60). All endoleaks detected by CTA or MRA were confirmed by enhanced ultrasound; the aneurysm diameter in these patients remained unchanged or increased. In patients without endoleaks on any imaging method, the sac diameter remained unchanged or decreased. Endoleaks disclosed by enhanced ultrasound alone, all type II, numbered 16 at 3 months, 6 at 12 months, and 3 at 24 months. In this group, the aneurysm diameter remained unchanged or increased. Enhanced ultrasound yielded 100% sensitivity in detecting endoleaks, but compared with CTA and MRA, all endoleaks detected by enhanced ultrasound alone were false positives (mean specificity 65%). Nevertheless, because changes in the postoperative aneurysm diameter were similar in patients with endoleaks detectable on CTA/MRA and on enhanced ultrasound ("true positives") and in those with endoleaks detectable only on enhanced ultrasound ("false positives"), some endoleaks were possibly "true positive" results. CONCLUSIONS: Enhanced ultrasound is a useful method in the long-term surveillance of endovascular aortic aneurysm repairs, possibly in association with CTA or MRA. Enhanced ultrasound also seems able to identify endoleaks missed by other imaging techniques, but this conclusion awaits further investigation. PMID: 12877601
Contrast-enhanced ultrasound imaging for aortic stent-graft surveillance / Giannoni, Maria Fabrizia; Giovanni, Palombo; Sbarigia, Enrico; Speziale, Francesco; Zaccaria, Alvaro; Paolo, Fiorani. - In: JOURNAL OF ENDOVASCULAR THERAPY. - ISSN 1526-6028. - STAMPA. - 10:2(2003), pp. 208-217. [10.1583/1545-1550(2003)010<0208:cuifas>2.0.co;2]
Contrast-enhanced ultrasound imaging for aortic stent-graft surveillance
GIANNONI, Maria Fabrizia;SBARIGIA, Enrico;SPEZIALE, Francesco;ZACCARIA, Alvaro;
2003
Abstract
J Endovasc Ther. 2003 Apr;10(2):208-17. Contrast-eJ Endovasc Ther. 2003 Apr;10(2):208-17. Contrast-enhanced ultrasound imaging for aortic stent-graft surveillance. Giannoni MF, Palombo G, Sbarigia E, Speziale F, Zaccaria A, Fiorani P. Department of Vascular Surgery, University of Rome La Sapienza, Rome, Italy. mariafabrizia.giannoni@uniroma1.it PURPOSE: To compare unenhanced and enhanced ultrasound imaging to computed tomographic angiography (CTA) or magnetic resonance angiography (MRA) for surveillance of aortic endografts. METHODS: Thirty consecutive patients (29 men; mean age 69 years, range 50-82) who underwent endovascular aortic aneurysm repair agreed to participate in a follow-up program. Patients underwent CTA (26/30) or MRA (4/30), plain abdominal radiography, and unenhanced and enhanced ultrasound examinations at 3, 12, and 24 months to evaluate aneurysm diameter, endoleaks, and graft patency. The accuracy of ultrasound was compared with CTA or MRA as the reference standards. RESULTS: Twenty-six patients reached the 24-month assessment (mean follow-up 30 months, range 6-60). All endoleaks detected by CTA or MRA were confirmed by enhanced ultrasound; the aneurysm diameter in these patients remained unchanged or increased. In patients without endoleaks on any imaging method, the sac diameter remained unchanged or decreased. Endoleaks disclosed by enhanced ultrasound alone, all type II, numbered 16 at 3 months, 6 at 12 months, and 3 at 24 months. In this group, the aneurysm diameter remained unchanged or increased. Enhanced ultrasound yielded 100% sensitivity in detecting endoleaks, but compared with CTA and MRA, all endoleaks detected by enhanced ultrasound alone were false positives (mean specificity 65%). Nevertheless, because changes in the postoperative aneurysm diameter were similar in patients with endoleaks detectable on CTA/MRA and on enhanced ultrasound ("true positives") and in those with endoleaks detectable only on enhanced ultrasound ("false positives"), some endoleaks were possibly "true positive" results. CONCLUSIONS: Enhanced ultrasound is a useful method in the long-term surveillance of endovascular aortic aneurysm repairs, possibly in association with CTA or MRA. Enhanced ultrasound also seems able to identify endoleaks missed by other imaging techniques, but this conclusion awaits further investigation. PMID: 12877601I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
