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©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
Follow-up of endovascular aortic aneurysm repair: Preliminary validation of digital tomosynthesis and contrast enhanced ultrasound in detection of medium- to long-term complications
Maria Antonietta Mazzei, Susanna Guerrini, Francesco Giuseppe Mazzei, Nevada Cioffi Squitieri, Dario Notaro, Gianmarco de Donato, Giuseppe Galzerano, Palmino Sacco, Francesco Setacci, Luca Volterrani, Carlo Setacci
Maria Antonietta Mazzei, Susanna Guerrini, Nevada Cioffi Squitieri, Dario Notaro, Luca Volterrani, Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging Unit, University of Siena, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy
Francesco Giuseppe Mazzei, Palmino Sacco, Diagnostic Imaging Unit, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy
Gianmarco de Donato, Giuseppe Galzerano, Carlo Setacci, Department of Medical, Surgical and Neuro Sciences, Vascular and Endovascular Surgery Unit, University of Siena, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy
Francesco Setacci, Department of General Surgery “P.Valdoni”, First School of Medicine, University of Rome “La Sapienza”, 00161 Rome, Italy
Author contributions: Mazzei MA, Guerrini S, Mazzei FG, Cioffi Squitieri N, Notaro D, de Donato G, Galzerano G, Sacco P and Setacci F made substantial contributions to conception and design of the study, and acquisition, analysis and interpretation of the data; Mazzei MA, Guerrini S and Setacci C contributed to drafting the article and revising it critically for important intellectual content; Mazzei MA, Volterrani L and Setacci C approved the final version to be published.
Institutional review board statement: The study was reviewed and approved by the University of Siena Institutional Review Board.
Clinical trial registration statement: None.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: None.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Maria Antonietta Mazzei, MD, Associate Professor of Radiology, Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging Unit, University of Siena, Azienda Ospedaliera Universitaria Senese, Viale Bracci 10, 53100 Siena, Italy. mariaantonietta.mazzei@unisi.it
Telephone: +39-0577-585700 Fax: +39-0577-44496
Received: August 29, 2015
Peer-review started: September 7, 2015
First decision: December 7, 2015
Revised: January 25, 2016
Accepted: February 16, 2016
Article in press: February 17, 2016
Published online: May 28, 2016
AIM: To validate the feasibility of digital tomosynthesis of the abdomen (DTA) combined with contrast enhanced ultrasound (CEUS) in assessing complications after endovascular aortic aneurysm repair (EVAR) by using computed tomography angiography (CTA) as the gold standard.
METHODS: For this prospective study we enrolled 163 patients (123 men; mean age, 65.7 years) referred for CTA for EVAR follow-up. CTA, DTA and CEUS were performed at 1 and 12 mo in all patients, with a maximum time interval of 2 d.
RESULTS: Among 163 patients 33 presented complications at CTA. DTA and CTA correlated for the presence of complications in 32/33 (96.96%) patients and for the absence of complications in 127/130 (97.69%) patients; the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of DTA were 97%, 98%, 91%, 99%, and 98%, respectively. CEUS and CTA correlated for the presence of complications in 19/33 (57.57%) patients and for the absence of complications in 129/130 (99.23%) patients; the sensitivity, specificity, PPV, NPV and accuracy of CEUS were 58%, 99%, 95%, 90%, and 91%, respectively. Sensitivity, specificity and accuracy of combining DTA and CEUS together in detecting EVAR complications were 77%, 98% and 95%, respectively.
CONCLUSION: Combining DTA and CEUS in EVAR follow-up has the potential to limit the use of CTA only in doubtful cases.
Core tip: Follow-up of endovascular aortic aneurysm repair: A preliminary study to validate the feasibility of digital tomosynthesis of the abdomen combined with contrast enhanced ultrasound.
