| Institution: | 1. Department of Interventional Radiology, Kawasaki Saiwai Hospital, 31-27, Omiya-Cho, Saiwai-Ku, Kawasaki, Kanagawa, 212-0014 Japan;2. Department of Radiology, Kawasaki Saiwai Hospital, 31-27, Omiya-Cho, Saiwai-Ku, Kawasaki, Kanagawa, 212-0014 Japan;3. Department of Radiology, St. Marianna University School of Medicine Hospital, 2-16-1, Sugao, Miyamae-Ku, Kawasaki, Kanagawa, Japan;1. Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, UT 160012, India;2. Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, UT 160012, India;3. Department of Cytopathology, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, UT 160012, India;4. Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, UT 160012, India;1. Department of Imaging, Division of Interventional Radiology, Massachusetts General Hospital, 55 Fruit Street, 290 Gray/Bigelow;2. Department of Imaging, Division of Diagnostic Imaging Physics, Massachusetts General Hospital, 55 Fruit Street, 290 Gray/Bigelow;3. Department of Imaging, Webster Center for Advanced Research and Education in Radiation, Massachusetts General Hospital, 55 Fruit Street, 290 Gray/Bigelow;4. Harvard Medical School, Boston, MA 02114;1. Discipline of Thoracic and Cardiovascular Surgery, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil;2. Department of Radiology, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil;3. Discipline of Thoracic and Cardiovascular Surgery, School of Medicine, University of São Paulo, São Paulo, SP, Brazil;1. Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada;2. Diagnostic Imaging Department, St. Joseph’s Healthcare Hamilton, 50 Charlton Ave. E, Hamilton, ON, Canada L8N 4A6 |
| Abstract: | PurposeTo 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 MethodsLow-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.ResultsAll 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).ConclusionsLow-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. |
