Jens Schneider MD, Presenter: Nothing to Disclose

Sascha Herber MD, Abstract Co-Author: Nothing to Disclose

Achim Neufang MD, Abstract Co-Author: Nothing to Disclose

Manfred Thelen MD, Abstract Co-Author: Nothing to Disclose

Michael B Pitton MD, Abstract Co-Author: Nothing to Disclose

To investigate the diagnostic accuracy of MRI and spiral CT for endoleak detection.

m52 patients, 48 men and 4 women (age 71.1 ± 6.9, range 55 to 82 years) underwent endovascular aneurysm repair. Follow-up data sets included spiral CT (slice thickness of 3mm, reconstruction interval 2 mm, unenhanced and biphasic contrast enhanced) and MRI (1.5 Tesla MR scanner, transverse T2w-TSE, T1w-Flash 2D unenhanced, Flash 3D angio and T1w-Flash 2D contrast enhanced) within 48 hours postinterventionally, at 3, 6, and 12 months and every year. The endoleak size was categorized as A < 3%; B > 3%–10%; C > 10%–30%, D > 30% of the maximum cross sectional aneurysm area. Consensus reading of CT and MRI was defined as the standard of reference.

141 of 252 data sets demonstrated evidence for endoleaks. The incidence of Type I, II, III, IV endoleaks, and combined endoleaks was 3.2%, 40.1%, 6.7%, 2.0%, and 4.0% respectively. Sensitivity for endoleak detection was 92.9%, 43.3%, 34.0%, and 37.6% for MRI, biphasic CT, uniphasic arterial CT, and uniphasic late CT respectively. The corresponding negative predictive values were 91.7%, 58.1%, 54.4%, and 55.8% respectively. The overall accuracy of endoleak sizing was 95.2%, 57.5%, 55.2%, and 56.8% for MRI, biphasic CT, uniphasic arterial CT, and uniphasic late CT respectively.

cMRI is significantly superior to biphasic CT for endoleak detection and rating of endoleak size, followed by uniphasic late and uniphasic arterial CT scans. Endoleak rates reported after endovascular aneurysm repair substantially depend on the imaging modalities used. Reporting standards for endoleak detection should be defined.

Schneider, J, Herber, S, Neufang, A, Thelen, M, Pitton, M, Endoleak Detection after Endovascular Aneurysm Repair: Sensitivity and Negative Predictive Value of MRI and Multi-slice CT.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4410367.html