Partovi Sasan, Trischman Thomas, Rafailidis Vasileios, Ganguli Suvranu, Rengier Fabian, Goerne Harold, Rajiah Prabhakar, Staub Daniel, Patel Indravadan J, Oliveira George, Ghoshhajra Brian
1 Department of Radiology, Section of Vascular and Interventional Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University , Cleveland, OH , USA.
2 Department of Radiology, AHEPA University General Hospital, Aristotle University of Thessaloniki , Thessaloniki , Greece.
Br J Radiol. 2018 Jul;91(1087):20180013. doi: 10.1259/bjr.20180013. Epub 2018 May 2.
Endoleaks are a common complication of endovascular aortic repair (EVAR). As a result, patients require lifelong imaging surveillance following EVAR. In current clinical practice, evaluation for endoleaks is predominantly performed with CT angiography (CTA). Due to the significant cumulative radiation burden associated with repetitive CTA imaging, as well as the repeated administration of nephrotoxic contrast agent, contrast-enhanced ultrasound (CEUS) and magnetic resonance angiography (MRA) have evolved as potential modalities for lifelong surveillance post-EVAR. In this paper, multimodality imaging, including CTA, CEUS and MRA, for the surveillance of endoleaks is discussed. Further, new CTA techniques for radiation reduction are elaborated. Additionally, imagery for three cases of aortic endoleak detection using CTA and five cases using MRA are presented. Imaging for different types of endoleaks with CTA, MRA and CEUS are presented. For lifelong endoleak surveillance post-EVAR, CTA is still regarded as the imaging modality of choice. However, advancements in CEUS and MRA technique enable partial replacement of CTA in certain patients.
内漏是血管腔内主动脉修复术（EVAR）的常见并发症。因此，患者在接受EVAR术后需要进行终身影像监测。在当前临床实践中，内漏评估主要通过CT血管造影（CTA）进行。由于重复进行CTA成像会带来显著的累积辐射负担，以及反复使用肾毒性造影剂，对比增强超声（CEUS）和磁共振血管造影（MRA）已逐渐成为EVAR术后终身监测的潜在方式。本文讨论了用于监测内漏的多模态成像，包括CTA、CEUS和MRA。此外，还阐述了减少辐射的新型CTA技术。此外，还展示了3例使用CTA检测主动脉内漏和5例使用MRA检测主动脉内漏的影像。介绍了使用CTA、MRA和CEUS对不同类型内漏的成像。对于EVAR术后的终身内漏监测，CTA仍被视为首选的成像方式。然而，CEUS和MRA技术的进步使得在某些患者中可以部分替代CTA。
