Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, HP E01.132, 3508 GA Utrecht, The Netherlands.
Eur J Vasc Endovasc Surg. 2013 Apr;45(4):340-50. doi: 10.1016/j.ejvs.2012.12.014. Epub 2013 Feb 9.
The purpose of this systematic review was to examine whether magnetic resonance imaging (MRI) or computed tomography angiography (CTA) is more sensitive for the detection of endoleaks in patients with abdominal aortic aneurysm (AAA) after EVAR.
Systematic review.
A systematic electronic search was performed. Articles were included when post-EVAR patients were evaluated by both MRI as index test and CTA as comparison. Methodological quality was assessed with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. Primary outcome was the proportion of patients in whom MRI detected additional endoleaks, which were not seen with CTA.
Eleven articles were included. The overall methodological quality of the articles was good. In total, 369 patients with 562 MRI and 562 CTA examinations were included. A total of 146 endoleaks were detected by CTA; MRI detected all but two of these endoleaks. With MRI 132 additional endoleaks were found.
MRI is more sensitive compared to CTA for the detection of post-EVAR endoleaks, especially for the detection of type II endoleaks. MRI should be considered in patients with continued AAA growth and negative or uncertain findings at CTA.
本系统评价旨在研究磁共振成像（MRI）或计算机断层血管造影（CTA）在腹主动脉瘤（AAA）患者 EVAR 后检测内漏方面的敏感性。
系统评价。
进行了系统的电子检索。当 MRI 作为索引试验和 CTA 作为比较在 EVAR 后患者中进行评估时，纳入了文章。使用诊断准确性研究的质量评估（QUADAS）工具评估方法学质量。主要结局是 MRI 检测到 CTA 未发现的附加内漏的患者比例。
纳入了 11 篇文章。文章的总体方法学质量良好。共有 369 例患者接受了 562 次 MRI 和 562 次 CTA 检查。CTA 共检测到 146 个内漏；MRI 检测到除了两个之外的所有内漏。MRI 还发现了 132 个附加内漏。
与 CTA 相比，MRI 对内漏的检测更敏感，尤其是对 II 型内漏的检测。在 CTA 检查阴性或不确定的情况下，应考虑在 AAA 持续生长的患者中使用 MRI。
