The value of contrast-enhanced ultrasound (CEUS) using a high-end ultrasound system in the characterization of endoleaks after endovascular aortic repair (EVAR)
Issue title: Developments in the application of high resolution ultrasound in clinical diagnostics
Affiliations: [a] Department of Clinical Radiology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany
| [b] Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, University Sapienza, Rome, Italy
Correspondence:
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Corresponding author: Dr. med. Johannes Rübenthaler, Department of Clinical Radiology, Interdisciplinary Ultrasound Center, University of Munich –Grosshadern Campus, Marchioninistr. 15, 81377 Munich, Germany. Tel.: +49 89 44007 3627; Fax: +49 89 44007 8832; E-mail: Johannes.Ruebenthaler@med.uni-muenchen.de.
Note: [1] These authors contributed equally to the study.
Abstract: PURPOSE: 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). MATERIAL AND METHODS: 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. RESULTS: 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. CONCLUSION: 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.
Keywords: Endoleak, EVAR, CEUS, high-end ultrasound system
