Follow-up evaluation of endoluminally treated abdominal aortic aneurysms with duplex ultrasonography: Validation with computed tomography
Follow-up evaluation of endoluminally treated abdominal aortic aneurysms with duplex ultrasonography: Validation with computed tomography
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DOI：
10.1067/mva.2001.112215
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发表时间：
2001-01-01
影响因子：
4.3
通讯作者：
Becquemin, JP
中科院分区：
文献类型：
--
作者：
d'Audiffret, A;Desgranges, P;Becquemin, JP
目的：目前越来越多的腹主动脉瘤患者正在接受腔内治疗。然而，内漏、狭窄和血栓的发生率约为25%至30%。因此，有必要制定一套严格的术后影像监控方案。本研究的目的是比较双功能超声(DU)和CT(CT)在腔内治疗主动脉瘤中的应用。方法：对89例患者在腔内治疗后1、3、6、12和24个月分别进行系列CT和DU随访。特别注意内漏和动脉瘤直径演变的存在。结果：DU检出I型14例，II型21例。在一个病例中，DU在CT上没有显示II型内漏，CT也没有确认DU发现的三个II型渗漏。只有1例DU的I型内漏为假阳性。与CT比较，DU的敏感性为96%，特异性为94%。对DU和CT测量的直径进行线性回归分析，两者具有良好的相关性。然而，可变性很高，表明一致性较差。在直径进化方面，45%的范围相同，73%的趋势相似。结论：与CT相比，DU是诊断内漏的一种准确的工具，但对内漏的测量价值不如CT。目前，DU是一种有用的工具，但CT仍然是腹主动脉瘤腔内治疗后评估的关键部分。在使用DU进行随访的机构中，研究人员应该进行质量控制研究，以避免潜在的重大错误。
Objective: A growing number of patients with abdominal aortic aneurysms are currently being offered endoluminal treatment. However, the incidence of endoleaks, stenosis, and thrombosis is around 25% to 30%. As a result, a strict postprocedure imaging surveillance protocol is necessary. The purpose of this study was to compare duplex ultrasonography (DU) and computed tomography (CT) for the follow-up of endoluminally treated aortic aneurysms.Methods: A total of 89 patients were followed up with serial CT and DU at 1, 3, 6, 12, and 24 months after endoluminal treatment. Special attention was directed toward the presence of endoleaks and aneurysm diameter evolution. Preoperative CT and DU were also reviewed to assess aneurysm diameter correlation.Results: With DU, 14 type I and 21 type II endoleaks were identified. In one case the DU did not visualize a type II endoleak present on CT, and CT did not confirm three type II leaks identified with DU. There was only one false-positive for type I endoleak with DU. The sensitivity of DU was 96% with a specificity of 94%, when compared with CT. A linear regression analysis of the diameters obtained with DU and CT revealed a good correlation. However, variability was high, indicating poor agreement. Regarding diameter evolution, the range was identical in 45%, and the trend was similar in 73%. However, in 9% of the cases, DU showed a decrease in diameter, whereas CT showed a significant increase.Conclusion: DU is an accurate tool for the diagnosis of endoleaks, but is less valuable for diameter measurements, when compared with CT. Currently, DU is a useful tool, but CT remains a key part of the postoperative evaluation after endoluminal treatment of abdominal aortic aneurysms. At institutions where DU is used for follow-up, researchers should perform quality control studies to avoid potentially significant errors.