Document Detail


Contrast-enhanced ultrasound versus computed tomographic angiography for surveillance of endovascular abdominal aortic aneurysm repair.
MedLine Citation:
PMID:  20363153     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To compare diagnostic accuracy between contrast-enhanced ultrasound (US) and computed tomographic (CT) angiography to detect changes in abdominal aortic aneurysm (AAA) size and endoleaks during follow-up after endovascular aneurysm repair (EVAR). MATERIALS AND METHODS: Between May 2006 and December 2008, 83 patients were consecutively enrolled for contrast-enhanced US and CT angiography imaging during surveillance after EVAR, yielding 127 paired examinations. Comparative analysis was performed for the anteroposterior and transverse maximal diameters of the aneurysm sac and for the presence or absence of endoleak, as determined by US and CT angiography. RESULTS: Contrast-enhanced US demonstrated significantly more endoleaks, predominantly of type II, compared with CT angiography (53% vs 22% of cases). The number of observed agreements was 77 of 127 (61%), indicating a low level of agreement (kappa value of 0.237). US was as accurate as CT angiography in the assessment of maximal aneurysm sac diameters, as shown by Bland-Altman analyses and low coefficients of variation (8.0% and 8.6%, respectively). The interobserver variability for AAA size measurement by US was low, given the interclass correlation coefficients of 0.99 and 0.98 for anteroposterior and transverse maximal diameters, respectively. CONCLUSIONS: Contrast-enhanced US may be an alternative to CT angiography in the follow-up of patients after EVAR. As US reduces exposure to the biologic hazards associated with lifelong annual CT angiography, including cumulative radiation dose and nephrotoxic contrast agent load, contrast-enhanced US might be considered as a substitute for CT angiography in the surveillance of patients after EVAR.
Authors:
Jan A Ten Bosch; Ellen V Rouwet; Cecile T H Peters; Linda Jansen; Hence J M Verhagen; Martin H Prins; Joep A W Teijink
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article     Date:  2010-04-02
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  21     ISSN:  1535-7732     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-30     Completed Date:  2010-09-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  638-43     Citation Subset:  IM    
Affiliation:
Department of Vascular Surgery, Atrium Medical Center, Heerlen, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angiography / methods*
Aortic Aneurysm, Abdominal / diagnosis*,  surgery*
Contrast Media
Female
Humans
Male
Phospholipids / diagnostic use*
Reproducibility of Results
Sensitivity and Specificity
Sulfur Hexafluoride / diagnostic use*
Surgery, Computer-Assisted / methods
Tomography, X-Ray Computed / methods*
Treatment Outcome
Ultrasonography / methods*
Vascular Surgical Procedures / methods*
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Phospholipids; 0/contrast agent BR1; 2551-62-4/Sulfur Hexafluoride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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