The value of ultrasound contrast agents in diagnosis endoleaks in patients after stent-graft implantation
Journal Title: Postępy Nauk Medycznych - Year 2012, Vol 25, Issue 5
Abstract
<b>Introduction.</b> To assess efficacy of contrast-enhanced ultrasound in detecting endoleaks to aneurysmal sac after EVAR.<br><b>Material and methods. </b>During the period of 3 years standard and contrast-enhanced ultrasound with the use of SonoVue were performed in 196 patients who underwent Endovascular aortic aneurysm repair (EVAR). Ultrasound examinations and spiral CT were done 12 months after EVAR. The evidence of endoleak was evaluated.<br><b>Results. </b>In conventional Doppler study type I endoleaks were diagnosed in 3 patients and type II in 9 patients: 6 from lumbar arteries (LA) and 3 from inferior mesenteric artery (IMA). Contrast-enhanced ultrasound examinations revealed type I endoleaks in 4 patients and type II endoleaks in 15: 9 from LA and 6 from IMA and showed mechanism of endoleaks: 4 complex type II endoleaks and 11 simple endoleaks were diagnosed. CT examinations detected type I endoleaks in 5 patients and type II from IMA in 7 patients and confirmed 6 endoleaks from IMA diagnosed with the use of Sono-Vue and indicated one additional endoleak from IMA. CT examinations showed only 8 type II endoleaks from LA. There was one more endoleak from LA diagnosed with the use of SonoVue, not detected at CT.<br><b>Conclusions.</b> The use of ultrasound contrast agents increased diagnostic efficacy of Doppler examinations for detecting type I and II endoleaks. This examination has comparable to CT value in detecting type II endoleaks, but additionally ultrasound examinations with the use of SonoVue show mechanism of endoleak and direction and velocities of blood flow.
Authors and Affiliations
Anna Drelich-Zbroja, Monika Miazga, Tomasz Jargiełło, Katarzyna Wojtal, Michał Sojka, Małgorzata Szczerbo-Trojanowska
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