Details

Autor(en) / Beteiligte

• Lehmkuhl, Lukas
• Andres, Claudia
• Lücke, Christian
• Foldyna, Borek
• Grothoff, Matthias
• Scheinert, Dierk
• Nitzsche, Stefan
• Gutberlet, Matthias

Titel

Dynamic CT angiography after abdominal aortic endovascular aneurysm repair: differences in contrast agent dynamics in the aorta and endoleaks--preliminary results

Ist Teil von

• Journal of vascular and interventional radiology, 2012-06, Vol.23 (6), p.744-750

Ort / Verlag

United States

Erscheinungsjahr

2012

Quelle

MEDLINE

Beschreibungen/Notizen

• To assess differences in aortic and endoleak enhancement in patients after endovascular aneurysm repair (EVAR) with dynamic computed tomography (CT) angiography. Twenty-one consecutive patients (mean age, 74.5 y ± 6; range, 61-88 y) with endoleaks after EVAR of the abdominal aorta were examined on a second-generation dual-source CT unit with 10 unidirectional scan phases (temporal resolution, 5 s; 80 kV; 120 reference-mAs; z-axis field of view, 283 mm), followed by a venous scan phase. Enhancement was assessed in aorta and endoleaks for all phases by density measurements. The diagnostic reliability of endoleak detection was assessed on a five-point confidence scale. In total, 26 endoleaks (type I, n = 1; type II, n = 25) were detected. The highest detection rate was found in phase 5 (22 s after threshold; P < .01 vs other dynamic phases). Mean peak aortic enhancement (560 HU ± 96) was present in an early arterial phase (phase 3, 12 s after threshold), whereas the mean peak endoleak enhancement (398 HU ± 174) for type II endoleaks was present later, in phase 4 (17 s after threshold). Despite perceived high diagnostic confidence in phases 1 and 2 (ie, typical arterial phase of biphasic CT protocol), only 23% and 62% of endoleaks were detected, respectively, whereas peak diagnostic confidence (phases 4 and 5) corresponded well with the maximum endoleak detection rate but decreased significantly in later phases (ie, 6-10). Preliminary dynamic CT angiography results in post-EVAR follow-up revealed notably different peaks of endoleak and aortic enhancement, which are not covered sufficiently by conventional biphasic CT protocols. Phase 5 demonstrated the highest type II endoleak detection rate, with high diagnostic confidence.