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Time-resolved CT angiography for the detection and classification of endoleaks.

Publication ,  Journal Article
Sommer, WH; Becker, CR; Haack, M; Rubin, GD; Weidenhagen, R; Schwarz, F; Nikolaou, K; Reiser, MF; Johnson, TR; Clevert, DA
Published in: Radiology
June 2012

PURPOSE: To assess the feasibility and diagnostic performance of time-resolved computed tomographic (CT) angiography in the detection and classification of endoleaks after endovascular aortic aneurysm repair (EVAR) in high-risk patients. MATERIALS AND METHODS: The study was approved by our ethics committee. Written informed consent was obtained from all participating patients. Fifty-four patients (42 male and 12 female patients; mean age, 70.9 years ± 9.3 [standard deviation]) with either thoracic (n = 8) or abdominal (n = 46) aortic aneurysms treated with a stent-graft were prospectively included. The patients were examined with a time-resolved CT angiographic protocol consisting of 12 low-dose phases (80 kVp; 120 mAs [effective]; scan range, 27 cm), with 60 mL of iomeprol. Patients with abdominal aneurysm repair also underwent contrast material-enhanced (CE) ultrasonography (US). The time delay between contrast enhancement within the stent lumen and the endoleak was measured. Effective radiation dose was calculated from the scanner protocols. Measures of diagnostic performance for the detection of endoleaks were calculated for time-resolved CT angiography, with CE US serving as the reference standard. RESULTS: All time-resolved CT angiographic data sets were diagnostic. Mean effective radiation dose was 14.6 mSv. Four thoracic and 19 abdominal endoleaks were identified by using time-resolved CT angiography. Seventeen of 19 abdominal endoleaks were confirmed with CE US. This rate resulted in a sensitivity of 94%, a specificity of 93%, a positive predictive value of 89%, and a negative predictive value of 96% for time-resolved CT angiography after abdominal EVAR. Type I endoleaks showed significantly earlier mean peak contrast enhancement (0.28 second ± 0.83) compared with that for type II endoleaks (9.17 seconds ± 3.59, P < .0001). CONCLUSION: Time-resolved CT angiography with 12 low-dose phases is feasible for patients after thoracic and abdominal EVAR. The protocol approximates the radiation dose of standard triphasic protocols. Its dynamic information differentiates types of endoleaks and shows high diagnostic performance.

Duke Scholars

Published In

Radiology

DOI

EISSN

1527-1315

Publication Date

June 2012

Volume

263

Issue

3

Start / End Page

917 / 926

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Time Factors
  • Sulfur Hexafluoride
  • Statistics, Nonparametric
  • Sensitivity and Specificity
  • Prospective Studies
  • Predictive Value of Tests
  • Phospholipids
  • Nuclear Medicine & Medical Imaging
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Sommer, W. H., Becker, C. R., Haack, M., Rubin, G. D., Weidenhagen, R., Schwarz, F., … Clevert, D. A. (2012). Time-resolved CT angiography for the detection and classification of endoleaks. Radiology, 263(3), 917–926. https://doi.org/10.1148/radiol.12111217
Sommer, Wieland H., Christoph R. Becker, Mareike Haack, Geoffrey D. Rubin, Rolf Weidenhagen, Florian Schwarz, Konstantin Nikolaou, Maximilian F. Reiser, Thorsten R. Johnson, and Dirk A. Clevert. “Time-resolved CT angiography for the detection and classification of endoleaks.Radiology 263, no. 3 (June 2012): 917–26. https://doi.org/10.1148/radiol.12111217.
Sommer WH, Becker CR, Haack M, Rubin GD, Weidenhagen R, Schwarz F, et al. Time-resolved CT angiography for the detection and classification of endoleaks. Radiology. 2012 Jun;263(3):917–26.
Sommer, Wieland H., et al. “Time-resolved CT angiography for the detection and classification of endoleaks.Radiology, vol. 263, no. 3, June 2012, pp. 917–26. Pubmed, doi:10.1148/radiol.12111217.
Sommer WH, Becker CR, Haack M, Rubin GD, Weidenhagen R, Schwarz F, Nikolaou K, Reiser MF, Johnson TR, Clevert DA. Time-resolved CT angiography for the detection and classification of endoleaks. Radiology. 2012 Jun;263(3):917–926.

Published In

Radiology

DOI

EISSN

1527-1315

Publication Date

June 2012

Volume

263

Issue

3

Start / End Page

917 / 926

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Time Factors
  • Sulfur Hexafluoride
  • Statistics, Nonparametric
  • Sensitivity and Specificity
  • Prospective Studies
  • Predictive Value of Tests
  • Phospholipids
  • Nuclear Medicine & Medical Imaging
  • Male