Duplex ultrasound evaluation of endoluminally treated aortic aneurysms with emphasis on diameter measurement: A comparison with computed tomography

Abstract

The aim of this study was to determine the accuracy of color Doppler ultrasound (CDUS) for endoleak detection and measurement of the aneurysm diameter after endovascular aortic aneurysm repair. Forty-eight CDUS and computed tomographic angiography (CTA) examinations performed concurrently on 29 patients who were treated with endovascular stent grafts for abdominal aortic aneurysms were included in the study. CTA and CDUS findings were retrospectively compared for aneurysm diameter, patency of the graft, and the presence of leaks in the aneurysm's lumen (the so-called "endoleaks"). The stent graft was patent in all patients. Including the follow-up examinations, endoleaks were detected in a total of 17 CTA studies. The sensitivity, specificity, and positive and negative predictive values for CDUS compared with CTA as the gold standard were 100%, 96%, 94.4%, and 100%, respectively. Kappa statistics showed a high level of agreement between CDUS ant CTA examinations (χ = 0.95). The aneurysm diameters measured with CDUS and CTA were significantly different, but within 5 mm of each other in 83% of patients. Provided that a strict CDUS protocol including spectral analysis of perigraft flow is used, CDUS is comparable to CTA for endoleak detection and measurement of the aneurysm diameter.