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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
A Journal on Vascular and Endovascular Surgery
Italian Journal of Vascular and Endovascular Surgery 2010 December;17(4):253-8
Is CEUS a valid alternative to CTA in endoleak’s detection?
Mauro R. 1, Maioli F. 1, Freyrie A. 1, Testi G. 1, Palumbo N. 1, Serra C. 2, Stella A. 1
1 Department of Vascular Surgery, Alma Mater Studiorum, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
2 Department of Internal Medicine and Gastroenterology, Alma Mater Studiorum, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
Aim. The aim of this study is to evaluate the diagnostic accuracy of second generation contrast enhancement ultrasound (CEUS) in comparison with Computed Tomography Angiography (CTA) to detect endoleaks (EL) in patients submitted to endovascular abdominal aortic aneurysm repair (EVAR).
Methods. This prospectively study was carried out from January 2005 to May 2007. CEUS and CTA exams were made on 122 patients submitted to EVAR. Each patient underwent both the exams during two-weeks period; the examination was performed by two blinded operators. CEUS examination was performed by using an intravenous bolus of second generation blood pool US agent SonoVue® (Bracco, Italy). A HDI 5 000 and IU22 (Philips) machines, equipped with 5-2 MHz curved-array probe and contrast specific software operating at low mechanical index and pulse invertion technology, were used. For type I, II and III EL, Cohen’s concordance Index (K) was used to compared each other (CEUS and CTA).
Results. Two-hundred and twenty CEUS and 220 CTA were performed on 122 patients. In 219 cases CEUS and CTA were concordant about type I EL with a Cohen’s K of 0.93. In 207 cases CEUS and CTA were concordant about type II EL with a Cohen’s K of 0.87. A complete concordance was observed for type III EL with a Cohen’s K of 1.
Conclusion. In our experience, CEUS was found to be as much accurate as CTA, in EL’s detection. So that, CEUS could replace CTA in the follow-up of patients submitted to EVAR.