Detection of endoleaks after endovascular repair of abdominal aortic aneurysm

Value of unenhanced and delayed helical CT acquisitions

Alla Rozenblit, Michael Patlas, Ayala T. Rosenbaum, Takao Okhi, Frank J. Veith, Mitchell P. Laks, Zina J. Ricci

Research output: Contribution to journalArticle

147 Citations (Scopus)

Abstract

PURPOSE: To assess unenhanced and delayed phase computed tomographic (CT) images combined with arterial phase images for detecting endoleaks after endovascular treatment for abdominal aortic aneurysm (AAA). MATERIALS AND METHODS: CT scans were retrospectively evaluated for the presence of endoleaks after endovascular treatment of AAAs in 33 patients with endoleak (positive group) and 40 patients without evidence of endoleak or aneurysm enlargement (negative group). All patients underwent unenhanced and biphasic contrast material-enhanced CT. The CT scans were reviewed in the following combinations: (a) arterial phase and unenhanced scans (uniphasic/unenhanced set), (b) arterial and delayed phase scans only (biphasic set), and (c) arterial and delayed phase scans with unenhanced scans (complete set). Each set was reviewed by two radiologists blinded to the diagnosis of endoleak. Findings were recorded as positive, negative, or indeterminate for endoleak. RESULTS: Within the positive group, endoleaks were diagnosed with the uniphasic/unenhanced, biphasic, and complete image sets in 30 (91%), 32 (97%), and 33 (100%) patients, respectively. With the uniphasic/unenhanced set, three (9%) endoleaks (seen only on delayed phase images) were missed. With the biphasic set, one (3%) endoleak was interpreted as indeterminate. Within the negative group, uniphasic/unenhanced, biphasic, and complete image sets were negative for endoleaks in 100%, 80%, and 100% of patients, respectively. With the biphasic set, results were indeterminate in 20% of cases. CONCLUSION: A delayed CT acquisition enables detection of additional endoleaks, while an unenhanced acquisition helps eliminate indeterminate results. Thus, both acquisitions contribute to accurate diagnosis of endoleaks when combined with an arterial phase acquisition.

Original languageEnglish (US)
Pages (from-to)426-433
Number of pages8
JournalRadiology
Volume227
Issue number2
DOIs
StatePublished - May 1 2003

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Endoleak
Abdominal Aortic Aneurysm
Contrast Media
Aneurysm

Keywords

  • Aneurysm, aortic
  • Aorta, CT
  • Computed tomography (CT), comparative studies
  • Computed tomography (CT), phase imaging
  • Grafts, interventional procedures

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Detection of endoleaks after endovascular repair of abdominal aortic aneurysm : Value of unenhanced and delayed helical CT acquisitions. / Rozenblit, Alla; Patlas, Michael; Rosenbaum, Ayala T.; Okhi, Takao; Veith, Frank J.; Laks, Mitchell P.; Ricci, Zina J.

In: Radiology, Vol. 227, No. 2, 01.05.2003, p. 426-433.

Research output: Contribution to journalArticle

Rozenblit, Alla ; Patlas, Michael ; Rosenbaum, Ayala T. ; Okhi, Takao ; Veith, Frank J. ; Laks, Mitchell P. ; Ricci, Zina J. / Detection of endoleaks after endovascular repair of abdominal aortic aneurysm : Value of unenhanced and delayed helical CT acquisitions. In: Radiology. 2003 ; Vol. 227, No. 2. pp. 426-433.
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abstract = "PURPOSE: To assess unenhanced and delayed phase computed tomographic (CT) images combined with arterial phase images for detecting endoleaks after endovascular treatment for abdominal aortic aneurysm (AAA). MATERIALS AND METHODS: CT scans were retrospectively evaluated for the presence of endoleaks after endovascular treatment of AAAs in 33 patients with endoleak (positive group) and 40 patients without evidence of endoleak or aneurysm enlargement (negative group). All patients underwent unenhanced and biphasic contrast material-enhanced CT. The CT scans were reviewed in the following combinations: (a) arterial phase and unenhanced scans (uniphasic/unenhanced set), (b) arterial and delayed phase scans only (biphasic set), and (c) arterial and delayed phase scans with unenhanced scans (complete set). Each set was reviewed by two radiologists blinded to the diagnosis of endoleak. Findings were recorded as positive, negative, or indeterminate for endoleak. RESULTS: Within the positive group, endoleaks were diagnosed with the uniphasic/unenhanced, biphasic, and complete image sets in 30 (91{\%}), 32 (97{\%}), and 33 (100{\%}) patients, respectively. With the uniphasic/unenhanced set, three (9{\%}) endoleaks (seen only on delayed phase images) were missed. With the biphasic set, one (3{\%}) endoleak was interpreted as indeterminate. Within the negative group, uniphasic/unenhanced, biphasic, and complete image sets were negative for endoleaks in 100{\%}, 80{\%}, and 100{\%} of patients, respectively. With the biphasic set, results were indeterminate in 20{\%} of cases. CONCLUSION: A delayed CT acquisition enables detection of additional endoleaks, while an unenhanced acquisition helps eliminate indeterminate results. Thus, both acquisitions contribute to accurate diagnosis of endoleaks when combined with an arterial phase acquisition.",
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T1 - Detection of endoleaks after endovascular repair of abdominal aortic aneurysm

T2 - Value of unenhanced and delayed helical CT acquisitions

AU - Rozenblit, Alla

AU - Patlas, Michael

AU - Rosenbaum, Ayala T.

AU - Okhi, Takao

AU - Veith, Frank J.

AU - Laks, Mitchell P.

AU - Ricci, Zina J.

PY - 2003/5/1

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N2 - PURPOSE: To assess unenhanced and delayed phase computed tomographic (CT) images combined with arterial phase images for detecting endoleaks after endovascular treatment for abdominal aortic aneurysm (AAA). MATERIALS AND METHODS: CT scans were retrospectively evaluated for the presence of endoleaks after endovascular treatment of AAAs in 33 patients with endoleak (positive group) and 40 patients without evidence of endoleak or aneurysm enlargement (negative group). All patients underwent unenhanced and biphasic contrast material-enhanced CT. The CT scans were reviewed in the following combinations: (a) arterial phase and unenhanced scans (uniphasic/unenhanced set), (b) arterial and delayed phase scans only (biphasic set), and (c) arterial and delayed phase scans with unenhanced scans (complete set). Each set was reviewed by two radiologists blinded to the diagnosis of endoleak. Findings were recorded as positive, negative, or indeterminate for endoleak. RESULTS: Within the positive group, endoleaks were diagnosed with the uniphasic/unenhanced, biphasic, and complete image sets in 30 (91%), 32 (97%), and 33 (100%) patients, respectively. With the uniphasic/unenhanced set, three (9%) endoleaks (seen only on delayed phase images) were missed. With the biphasic set, one (3%) endoleak was interpreted as indeterminate. Within the negative group, uniphasic/unenhanced, biphasic, and complete image sets were negative for endoleaks in 100%, 80%, and 100% of patients, respectively. With the biphasic set, results were indeterminate in 20% of cases. CONCLUSION: A delayed CT acquisition enables detection of additional endoleaks, while an unenhanced acquisition helps eliminate indeterminate results. Thus, both acquisitions contribute to accurate diagnosis of endoleaks when combined with an arterial phase acquisition.

AB - PURPOSE: To assess unenhanced and delayed phase computed tomographic (CT) images combined with arterial phase images for detecting endoleaks after endovascular treatment for abdominal aortic aneurysm (AAA). MATERIALS AND METHODS: CT scans were retrospectively evaluated for the presence of endoleaks after endovascular treatment of AAAs in 33 patients with endoleak (positive group) and 40 patients without evidence of endoleak or aneurysm enlargement (negative group). All patients underwent unenhanced and biphasic contrast material-enhanced CT. The CT scans were reviewed in the following combinations: (a) arterial phase and unenhanced scans (uniphasic/unenhanced set), (b) arterial and delayed phase scans only (biphasic set), and (c) arterial and delayed phase scans with unenhanced scans (complete set). Each set was reviewed by two radiologists blinded to the diagnosis of endoleak. Findings were recorded as positive, negative, or indeterminate for endoleak. RESULTS: Within the positive group, endoleaks were diagnosed with the uniphasic/unenhanced, biphasic, and complete image sets in 30 (91%), 32 (97%), and 33 (100%) patients, respectively. With the uniphasic/unenhanced set, three (9%) endoleaks (seen only on delayed phase images) were missed. With the biphasic set, one (3%) endoleak was interpreted as indeterminate. Within the negative group, uniphasic/unenhanced, biphasic, and complete image sets were negative for endoleaks in 100%, 80%, and 100% of patients, respectively. With the biphasic set, results were indeterminate in 20% of cases. CONCLUSION: A delayed CT acquisition enables detection of additional endoleaks, while an unenhanced acquisition helps eliminate indeterminate results. Thus, both acquisitions contribute to accurate diagnosis of endoleaks when combined with an arterial phase acquisition.

KW - Aneurysm, aortic

KW - Aorta, CT

KW - Computed tomography (CT), comparative studies

KW - Computed tomography (CT), phase imaging

KW - Grafts, interventional procedures

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