• European radiology · May 2017

    Abdominal aortic aneurysm follow-up by shear wave elasticity imaging after endovascular repair in a canine model.

    • Antony Bertrand-Grenier, Sophie Lerouge, An Tang, Eli Salloum, Eric Therasse, Claude Kauffmann, Hélène Héon, Igor Salazkin, Guy Cloutier, and Gilles Soulez.
    • Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada.
    • Eur Radiol. 2017 May 1; 27 (5): 2161-2169.

    ObjectivesTo investigate if shear wave imaging (SWI) can detect endoleaks and characterize thrombus organization in abdominal aortic aneurysms (AAAs) after endovascular aneurysm repair.MethodsStent grafts (SGs) were implanted in 18 dogs after surgical creation of type I endoleaks (four AAAs), type II endoleaks (13 AAAs) and no endoleaks (one AAA). Color flow Doppler ultrasonography (DUS) and SWI were performed before SG implantation (baseline), on days 7, 30 and 90 after SG implantation, and on the day of the sacrifice (day 180). Angiography, CT scans and macroscopic tissue sections obtained on day 180 were evaluated for the presence, size and type of endoleaks, and thrombi were characterized as fresh or organized. Endoleak areas in aneurysm sacs were identified on SWI by two readers and compared with their appearance on DUS, CT scans and macroscopic examination. Elasticity moduli were calculated in different regions (endoleaks, and fresh and organized thrombi).ResultsAll 17 endoleaks (100 %) were identified by reader 1, whereas 16 of 17 (94 %) were detected by reader 2. Elasticity moduli in endoleaks, and in areas of organized thrombi and fresh thrombi were 0.2 ± 0.4, 90.0 ± 48.2 and 13.6 ± 4.5 kPa, respectively (P < 0.001 between groups). SWI detected endoleaks while DUS (three endoleaks) and CT (one endoleak) did not.ConclusionsSWI has the potential to detect endoleaks and evaluate thrombus organization based on the measurement of elasticity.Key Points• SWI has the potential to detect endoleaks in post-EVAR follow-up. • SWI has the potential to characterize thrombus organization in post-EVAR follow-up. • SWI may be combined with DUS in post-EVAR surveillance of endoleak.

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