Doppler ultrasound and contrast-enhanced ultrasound in detection of stent stenosis after iliac vein stenting

Hong Liu,Dong Wang,Miao Wei,Xiaoping Ye,Yu Zhao,Jing Wang,Zheng Chen,Fajin Lv

doi:10.1186/s12872-020-01840-3

Abstract

BackgroundTo compare the diagnostic accuracy of Doppler ultrasound (DUS) with contrast-enhanced ultrasound (CEUS) for detection of iliac vein stent stenosis using multidetector computed tomography venography (MDCTV) as the reference method.MethodsPatients with iliac vein obstructive disease treated with nitinol stents (Smart Control, Cordis, USA) between January 2016 and December 2017 were consecutively included in this study. DUS, CEUS, and MDCTV were carried out in all patients within one week of each other at 1 year post stenting to investigate the presence of stent compression and in-stent restenosis (ISR).ResultsThe study included 139 patients (87 females; mean age 58 ± 15 years). For detecting stent compression, the kappa coefficient between the ultrasound modality of gray-scale imaging and MDCTV was 0.901, indicating very good agreement between these two modalities. ISR was detected in 50, 61, and 65 patients by DUS, CEUS, and MDCTV, respectively. DUS and CEUS (kappa = 0.449) and DUS and MDCTV (kappa = 0.516) had moderate agreement for ISR diagnosis, while for which CEUS and MDCTV (kappa 0.884) had very good agreement. The sensitivity and specificity of DUS and CEUS for diagnosing ISR were 63.1% and 90.8%, 87.8% and 97.3%, respectively.ConclusionsCEUS is probably superior to DUS in terms of diagnostic accuracy for the follow-up of patients with iliac vein stent stenosis.

Highlights

To compare the diagnostic accuracy of Doppler ultrasound (DUS) with contrast-enhanced ultrasound (CEUS) for detection of iliac vein stent stenosis using multidetector computed tomography venography (MDCTV) as the reference method
The purpose of this study was to compare the diagnostic accuracy of DUS with CEUS for detection of iliac vein stent stenosis using MDCTV as the reference method
The main inclusion criteria were iliac vein compression syndrome (IVCS) patients associated with venous insufficiency (CEAP ≥ C3) or acute deep venous thrombosis (DVT), post-thrombotic syndrome (PTS) patients with Villalta score > 4 and CEAP ≥ C3 and the age range was 18–80 years old

Summary

Introduction

To compare the diagnostic accuracy of Doppler ultrasound (DUS) with contrast-enhanced ultrasound (CEUS) for detection of iliac vein stent stenosis using multidetector computed tomography venography (MDCTV) as the reference method. Iliac vein stenting has been demonstrated to be safe and is associated with good clinical results [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15]. IVUS is limited in routine follow-ups because of its high cost and invasive nature and is performed in only a minority of patients needed a secondary procedure Noninvasive modalities, such as multidetector computed tomography venography (MDCTV), have replaced the traditional gold standard of invasive imaging and provide. To the best of our knowledge, the value of CEUS in the diagnosis of iliac vein stent stenosis has not been previously reported

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