Format

Send to

Choose Destination
Eur Radiol. 2017 Jan;27(1):336-344. Epub 2016 Mar 24.

Endoleak detection after endovascular aneurysm repair using unenhanced MRI with flow suppression technique: Feasibility study in comparison with contrast-enhanced CT.

Author information

1
Department of Radiology Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan. moriken@md.tsukuba.ac.jp.
2
Department of Radiology Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
3
Department of Cardiovascular Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
4
Department of Radiology, Hitachi General Hospital, 2-1-1 Jonancho, Hitachi, Ibaraki, 317-0077, Japan.
5
Department of Radiology, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan.
6
Department of Radiology, Ibaraki Prefectural Central Hospital, 6528 Koibuchi, Kasama, Ibaraki, 309-1793, Japan.

Abstract

OBJECTIVES:

To evaluate the feasibility of unenhanced motion-sensitized-driven equilibrium (MSDE)-prepared balanced turbo field echo (BTFE) sequences for detecting endoleaks after endovascular aneurysm repair (EVAR).

METHODS:

Forty-six patients treated with EVAR for aortic and/or iliac arterial aneurysms underwent contrast-enhanced CT and MSDE-prepared BTFE sequences with and without flow suppression. Two independent observers reviewed these sequences and their subtraction images and assigned confidence levels for detecting endoleaks. Relative contrast values were calculated by dividing signal intensities by those of paraspinal muscles. CT provided the reference standard.

RESULTS:

CT showed types I and II endoleaks in one and ten patients, respectively. Areas under receiver operating characteristic curves were 0.92 and 0.97 for observers 1 and 2, respectively. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value of both observers were 91 (10/11), 91(32/35), 91 (42/46), 77 (10/13) and 97 % (32/33), respectively. Relative contrast values of endoleaks and flowing blood significantly decreased by flow suppression on MSDE-prepared BTFE images (P = 0.002 and P < 0.0001 respectively), and were significantly higher than those of the excluded aneurysms on subtraction images (P = 0.003 and P = 0.001, respectively).

CONCLUSIONS:

Unenhanced MSDE-prepared BTFE sequences are feasible for detecting endoleaks.

KEY POINTS:

• Flow suppression significantly reduces endoleak signals on MSDE-prepared BTFE images. • Subtraction images of MSDE-prepared BTFE sequences ± flow suppression demonstrate endoleaks. • MSDE-prepared BTFE sequences indicate high diagnostic values (>90 %) except PPV (77 %). • MSDE-prepared BTFE sequences need further refinement to reduce false positives. • Endoleaks can be detected without contrast injection using MSDE-prepared BTFE sequences.

KEYWORDS:

Aortic aneurysm; Endoleak; Endovascular procedures; Iliac aneurysm; Magnetic resonance imaging

PMID:
27011375
DOI:
10.1007/s00330-016-4315-5
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center