Department of Radiology, University of California, San Francisco, 94143-0628, USA.
AJR Am J Roentgenol. 2011 Jul;197(1):234-40. doi: 10.2214/AJR.10.4566.
The purpose of this study is to investigate which CT features of type II endoleaks following abdominal aortic aneurysm (AAA) endoluminal stent-graft repair can be used to predict clinical outcome.
We retrospectively identified 59 patients with type II endoleak after endovascular repair of an AAA with CT of the abdomen and pelvis. Patients were stratified into two groups: those who did (n = 23) and those who did not (n = 35) require reintervention. CT characteristics of type II endoleaks were recorded and correlated with the clinical outcome.
The CT features showing the strongest association with the clinical outcome were the transverse diameter of the endoleak cavity (mean, 1.13 cm in the nonreintervention group vs 1.85 cm in the reintervention group; p = 0.007) and the maximum diameter of the vessel communicating with the endoleak (0.34 vs 0.40 cm; p = 0.046). The transverse diameter of the endoleak cavity on arterial phase imaging had the greatest predictive capability, with an area under the receiver operating characteristic curve of 0.74. A transverse diameter greater than 1.42 cm had a positive predictive value of 0.71 and a negative predictive value of 0.82. The anteroposterior diameter, location, and heterogeneity of the endoleak cavity and the number of patent communicating vessels did not correlate well with clinical outcome. The correlation between endoleak cavity measurements and clinical outcome was independent of the aneurysm size.
There are identifiable CT features associated with the clinical outcome of patients with type II endoleak that have moderate predictive capabilities.
本研究旨在探讨腹主动脉瘤（AAA）血管内支架修复术后 II 型内漏的 CT 特征，以预测临床结局。
我们回顾性分析了 59 例接受腹盆部 CT 检查的 AAA 血管内修复术后 II 型内漏患者。将患者分为两组：需要（n=23）和不需要（n=35）再次介入治疗。记录 II 型内漏的 CT 特征，并与临床结局相关联。
与临床结局相关性最强的 CT 特征是内漏腔的横径（非再介入组的平均直径为 1.13cm，再介入组为 1.85cm；p=0.007）和与内漏相通的血管最大直径（0.34cm 对 0.40cm；p=0.046）。动脉期图像上的内漏腔横径具有最大的预测能力，受试者工作特征曲线下面积为 0.74。横径大于 1.42cm 时，阳性预测值为 0.71，阴性预测值为 0.82。内漏腔的前后径、位置、异质性以及通畅的交通血管数量与临床结局相关性不佳。内漏腔测量值与临床结局的相关性与动脉瘤大小无关。
II 型内漏患者的 CT 特征与临床结局相关，具有中等的预测能力。
