Yuya Koike1, Kazufumi Ishida2, Soichiro Hase3, Yasuyuki Kobayashi4, Jun-Ichi Nishimura3, Motoshige Yamasaki3, Norifumi Hosaka3. 1. Department of Interventional Radiology, Kawasaki Saiwai Hospital, 31-27, Omiya-Cho, Saiwai-Ku, Kawasaki, Kanagawa, 212-0014 Japan. Electronic address: r06118@hotmail.co.jp. 2. Department of Radiology, Kawasaki Saiwai Hospital, 31-27, Omiya-Cho, Saiwai-Ku, Kawasaki, Kanagawa, 212-0014 Japan. 3. Department of Interventional Radiology, Kawasaki Saiwai Hospital, 31-27, Omiya-Cho, Saiwai-Ku, Kawasaki, Kanagawa, 212-0014 Japan. 4. Department of Radiology, St. Marianna University School of Medicine Hospital, 2-16-1, Sugao, Miyamae-Ku, Kawasaki, Kanagawa, Japan.
Abstract
PURPOSE: To assess the feasibility and diagnostic performance of dynamic volumetric computed tomography (CT) angiography with large-area detectors in the detection and classification of endoleaks after endovascular aneurysm repair (EVAR). MATERIALS AND METHODS: Low-dose dynamic volumetric CT angiography performed with the patient in Fowler position was used to scan the entire stent graft with a 16-cm-area detector during the first follow-up examination after EVAR. There were 39 consecutive patients (36 men and 3 women; mean age, 74 y ± 8.7) examined with approximately 14-20 intermittent scans (temporal resolution, 2 s; scan range, 160 mm). The effective radiation dose, image quality, interobserver and intraobserver agreement for endoleak detection, and time delay between peak enhancement of the aorta and endoleaks were evaluated. RESULTS: All examinations with the patient in Fowler position enabled the entire stent graft to be scanned and were rated as diagnostic. The mean effective radiation dose was 13.1 mSv. Endoleaks were detected in eight patients (type Ia, n = 1; type II, n = 6; type III, n = 1). Interobserver agreement (κ = 0.794) and intraobserver agreement (κ = 1.00) for detection of endoleaks were excellent. The mean time delay between peak enhancement of the aorta and the endoleaks was significantly less for type I/III endoleaks (2.0 s ± 0) compared with type II endoleaks (5.3 s ± 1.0; P < .001). CONCLUSIONS: Low-dose dynamic volumetric CT angiography performed with the patient in Fowler position is feasible after EVAR. Dynamic information, including cine imaging, the timing of peak enhancement, and the Hounsfield units index, is useful in detecting and classifying endoleaks.
PURPOSE: To assess the feasibility and diagnostic performance of dynamic volumetric computed tomography (CT) angiography with large-area detectors in the detection and classification of endoleaks after endovascular aneurysm repair (EVAR). MATERIALS AND METHODS: Low-dose dynamic volumetric CT angiography performed with the patient in Fowler position was used to scan the entire stent graft with a 16-cm-area detector during the first follow-up examination after EVAR. There were 39 consecutive patients (36 men and 3 women; mean age, 74 y ± 8.7) examined with approximately 14-20 intermittent scans (temporal resolution, 2 s; scan range, 160 mm). The effective radiation dose, image quality, interobserver and intraobserver agreement for endoleak detection, and time delay between peak enhancement of the aorta and endoleaks were evaluated. RESULTS: All examinations with the patient in Fowler position enabled the entire stent graft to be scanned and were rated as diagnostic. The mean effective radiation dose was 13.1 mSv. Endoleaks were detected in eight patients (type Ia, n = 1; type II, n = 6; type III, n = 1). Interobserver agreement (κ = 0.794) and intraobserver agreement (κ = 1.00) for detection of endoleaks were excellent. The mean time delay between peak enhancement of the aorta and the endoleaks was significantly less for type I/III endoleaks (2.0 s ± 0) compared with type II endoleaks (5.3 s ± 1.0; P < .001). CONCLUSIONS: Low-dose dynamic volumetric CT angiography performed with the patient in Fowler position is feasible after EVAR. Dynamic information, including cine imaging, the timing of peak enhancement, and the Hounsfield units index, is useful in detecting and classifying endoleaks.
Authors: Georg Apfaltrer; Francesco Lavra; U Joseph Schoepf; Marco Scarabello; Ricardo Yamada; Marly van Assen; Akos Varga-Szemes; Brian E Jacobs; Maximilian J Bauer; William T Greenberg; Marcelo Guimaraes; Luca Saba; Carlo N De Cecco Journal: PLoS One Date: 2021-01-07 Impact factor: 3.240
Authors: Andrew G Sherrah; Stuart M Grieve; Richmond W Jeremy; Paul G Bannon; Michael P Vallely; Rajesh Puranik Journal: Front Cardiovasc Med Date: 2015-02-19