Rübenthaler J, Reiser M, Cantisani V, Rjosk-Dendorfer D, Clevert D A
Department of Clinical Radiology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany.
Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, University Sapienza, Rome, Italy.
Clin Hemorheol Microcirc. 2017;66(4):283-292. doi: 10.3233/CH-179102.
To evaluate the value of contrast-enhanced ultrasound (CEUS) using a high-end ultrasound system in the characterization of endoleaks after endovascular aortic repair (EVAR).
In this mono-center study, 41 patients were retrospectively analyzed after being examined using a modern high-end ultrasound system (RS80A with Prestige, Samsung Medison Co., Ltd., Seoul, Korea). The maximum diameters of the aneurysms were measured in two planes (right-left and ventral-dorsal). The performance of Color Doppler in comparison to CEUS was evaluated and CEUS was considered as the gold standard in endoleaks detection.
41 patients were included in the study. Between June and December 2016, mostly male patients (n = 38; 92,7%) were examined, corresponding to the incidence of abdominal aortic aneurysms in the population. Average age was 75±8 years (range 58-100 years). Average diameter of the treated aneurysm-sacs was 5,04±1.5 cm (range 2.7-10.5 cm) in the right-left plane and 4,75±1.36 cm (range 2.8-8.9 cm) in the ventral-dorsal plane. Using CEUS as the gold standard endoleaks could be detected in 28 patients (68,3%) with 13 patients not showing an endoleak after EVAR. Color Doppler showed a sensitivity of 32.1%, a specificity of 92.3%, a positive predictive value (PPV) of 90.0% and a negative predictive value (NPV) of 38,7% compared to CEUS being the gold standard.
CEUS after EVAR using a modern high-end ultrasound system is a fast and cost-effective imaging modality for the detection and follow-up of endoleaks with superior benefits compared to Color Doppler. CEUS remains the initial standard-of-care examination for follow-up.
评估使用高端超声系统的超声造影（CEUS）在血管腔内主动脉修复术（EVAR）后内漏特征分析中的价值。
在这项单中心研究中，对41例使用现代高端超声系统（韩国首尔三星麦迪逊有限公司的带有Prestige的RS80A）检查后的患者进行回顾性分析。在两个平面（左右和腹背）测量动脉瘤的最大直径。评估了彩色多普勒与CEUS相比的性能，并将CEUS视为内漏检测的金标准。
41例患者纳入研究。在2016年6月至12月期间，主要检查男性患者（n = 38；92.7%），这与人群中腹主动脉瘤的发病率相符。平均年龄为75±8岁（范围58 - 100岁）。在左右平面，治疗后动脉瘤囊的平均直径为5.04±1.5 cm（范围2.7 - 10.5 cm），在腹背平面为4.75±1.36 cm（范围2.8 - 8.9 cm）。以CEUS作为金标准，在28例患者（68.3%）中检测到内漏，13例患者在EVAR后未显示内漏。与作为金标准的CEUS相比，彩色多普勒显示的敏感性为32.1%，特异性为92.3%，阳性预测值（PPV）为90.0%，阴性预测值（NPV）为38.7%。
使用现代高端超声系统在EVAR后进行CEUS是一种快速且经济高效的成像方式，用于内漏的检测和随访，与彩色多普勒相比具有更大优势。CEUS仍然是随访的初始标准护理检查。
