• R Motta, L Rubaltelli, R Vezzaro, V Vida, P Marchesi, R Stramare, A Zanon, M Battistel, M Sommavilla, and D Miotto.
• Sezione Radiologia, Dipartimento di Scienze Medico-Diagnostiche e Terapie Speciali, Università di Padova, Via Giustiniani 2, Padua, Italy. raffaella.motta@unipd.it
• Radiol Med. 2012 Sep 1; 117 (6): 1079-92.

PurposeContrast-enhanced ultrasonography (CEUS) is an appealing alternative to computed tomography angiography (CTA) for the follow-up of patients who underwent endovascular abdominal aortic aneurysm repair (EVAR). We sought to evaluate the accuracy of CEUS compared with a particularly tailored protocol of CTA performed with a 64-row multidetector CT.Materials And MethodsThe study prospectively enrolled 88 consecutive patients for CEUS and CTA imaging during follow-up after EVAR, yielding 142 paired examinations. The outcome is represented by three main goals: identification and characterisation of endoleaks, evaluation of graft patency and measurement of aneurysm diameter. Triple-phase CTA was the gold standard.ResultsSensitivity and specificity of CEUS compared with CTA in endoleak and graft patency evaluation were 91.89% and 100% and 72% and 100%, respectively. A very high correlation between CTA and CEUS diameter measurements was established. CEUS did not appear superior to CTA in endoleak detection, probably because a tailored CTA protocol with a delayed phase (180 s) allows detection of low-flow endoleaks.ConclusionsPatient management was not different following CEUS and CTA results. CTA cannot yet be completely replaced, but several limitations (radiation exposure, contrast agent) encourage redefining the routine follow-up imaging modality. We suggest an algorithm of surveillance alternating CTA and CEUS.

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