Vito Cantisani1, Emanuele David2, Donatella Ferrari1, Fabrizio Fanelli1, Luca Di Marzo3, Carlo Catalano1, Filippo Benedetto2, Domenico Spinelli4, Athanasios Katsargyris5, Alfredo Blandino2, Giorgio Ascenti2, Ferdinando D'Ambrosio1. 1. Department of Radiology, Oncology, and Anatomy Pathology, "Sapienza" University of Rome, Rome, Italy. 2. Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy. 3. Department of Surgery Pietro Valdoni, Sapienza University, Rome, Italy. 4. Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy. Electronic address: dr.spinelli@me.com. 5. Department of Vascular and Endovascular Surgery, Paracelsus Medical University, KlinikumNürnberg, Nuremberg, Germany.
Abstract
BACKGROUND: The aim of the study was to evaluate the diagnostic effectiveness of color Doppler ultrasound (CDUS) with superb microvascular imaging (SMI) compared to contrast-enhanced ultrasound (CEUS), computed tomography (CT) multislice angiography (64 slices), and angiography required for therapeutic reasons, for follow-up after endovascular aneurysm repair (EVAR). METHODS: From March 2014 to May 2015, 57 patients treated with EVAR were evaluated with CT, CEUS, CDUS, SMI, and angiography in cases requiring treatment. Evaluation included sac diameter, stent-graft integrity, identification, and classification of endoleaks. Sensitivity, specificity, accuracy, and negative and positive predictive values were evaluated for each modality of endoleak identification. RESULTS: Eight endoleaks (16.3%), all type II, were documented. Sensitivity of CT, CEUS, CDUS and SMI was 88%, 100%, 63%, and 75%, respectively. Specificity of CT, CEUS, CDUS, and SMI was 100%, 100%, 96%, and 98%, respectively With SMI, CDUS sensitivity significantly increased, whereas specificity did not register great differences. CONCLUSIONS: SMI was more accurate than CDUS but less accurate than CEUS and CT to identify endoleaks after EVAR. SMI could be concretely used in the follow-up phase to increase CDUS accuracy especially in patients who cannot be studied with CEUS or CT.
BACKGROUND: The aim of the study was to evaluate the diagnostic effectiveness of color Doppler ultrasound (CDUS) with superb microvascular imaging (SMI) compared to contrast-enhanced ultrasound (CEUS), computed tomography (CT) multislice angiography (64 slices), and angiography required for therapeutic reasons, for follow-up after endovascular aneurysm repair (EVAR). METHODS: From March 2014 to May 2015, 57 patients treated with EVAR were evaluated with CT, CEUS, CDUS, SMI, and angiography in cases requiring treatment. Evaluation included sac diameter, stent-graft integrity, identification, and classification of endoleaks. Sensitivity, specificity, accuracy, and negative and positive predictive values were evaluated for each modality of endoleak identification. RESULTS: Eight endoleaks (16.3%), all type II, were documented. Sensitivity of CT, CEUS, CDUS and SMI was 88%, 100%, 63%, and 75%, respectively. Specificity of CT, CEUS, CDUS, and SMI was 100%, 100%, 96%, and 98%, respectively With SMI, CDUS sensitivity significantly increased, whereas specificity did not register great differences. CONCLUSIONS:SMI was more accurate than CDUS but less accurate than CEUS and CT to identify endoleaks after EVAR. SMI could be concretely used in the follow-up phase to increase CDUS accuracy especially in patients who cannot be studied with CEUS or CT.
Authors: Wolfgang Kratzer; Melanie Güthle; Felix Dobler; Thomas Seufferlein; Tilmann Graeter; Julian Schmidberger; Thomas Fe Barth; Jochen Klaus Journal: Quant Imaging Med Surg Date: 2022-03
Authors: Marco Curti; Filippo Piacentino; Federico Fontana; Christian Ossola; Andrea Coppola; Paolo Marra; Antonio Basile; Anna Maria Ierardi; Gianpaolo Carrafiello; Giulio Carcano; Matteo Tozzi; Gabriele Piffaretti; Massimo Venturini Journal: Diagnostics (Basel) Date: 2022-02-18