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01-01-2017 | Magnetic Resonance

Endoleak detection after endovascular aneurysm repair using unenhanced MRI with flow suppression technique: Feasibility study in comparison with contrast-enhanced CT

Authors: Kensaku Mori, Tsukasa Saida, Fujio Sato, Yoko Uchikawa, Takahiro Konishi, Toshitaka Ishiguro, Takashi Hiyama, Sodai Hoshiai, Yoshikazu Okamoto, Katsuhiro Nasu, Manabu Minami

Published in: European Radiology | Issue 1/2017

Abstract

Objectives

To evaluate the feasibility of unenhanced motion-sensitized-driven equilibrium (MSDE)-prepared balanced turbo field echo (BTFE) sequences for detecting endoleaks after endovascular aneurysm repair (EVAR).

Methods

Forty-six patients treated with EVAR for aortic and/or iliac arterial aneurysms underwent contrast-enhanced CT and MSDE-prepared BTFE sequences with and without flow suppression. Two independent observers reviewed these sequences and their subtraction images and assigned confidence levels for detecting endoleaks. Relative contrast values were calculated by dividing signal intensities by those of paraspinal muscles. CT provided the reference standard.

Results

CT showed types I and II endoleaks in one and ten patients, respectively. Areas under receiver operating characteristic curves were 0.92 and 0.97 for observers 1 and 2, respectively. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value of both observers were 91 (10/11), 91(32/35), 91 (42/46), 77 (10/13) and 97 % (32/33), respectively. Relative contrast values of endoleaks and flowing blood significantly decreased by flow suppression on MSDE-prepared BTFE images (P = 0.002 and P < 0.0001 respectively), and were significantly higher than those of the excluded aneurysms on subtraction images (P = 0.003 and P = 0.001, respectively).

Conclusions

Unenhanced MSDE-prepared BTFE sequences are feasible for detecting endoleaks.

Key points

• Flow suppression significantly reduces endoleak signals on MSDE-prepared BTFE images.

• Subtraction images of MSDE-prepared BTFE sequences ± flow suppression demonstrate endoleaks.

• MSDE-prepared BTFE sequences indicate high diagnostic values (>90 %) except PPV (77 %).

• MSDE-prepared BTFE sequences need further refinement to reduce false positives.

• Endoleaks can be detected without contrast injection using MSDE-prepared BTFE sequences.

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Title: Endoleak detection after endovascular aneurysm repair using unenhanced MRI with flow suppression technique: Feasibility study in comparison with contrast-enhanced CT
Authors: Kensaku Mori
Tsukasa Saida
Fujio Sato
Yoko Uchikawa
Takahiro Konishi
Toshitaka Ishiguro
Takashi Hiyama
Sodai Hoshiai
Yoshikazu Okamoto
Katsuhiro Nasu
Manabu Minami
Publication date: 01-01-2017
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 1/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-016-4315-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Endoleak detection after endovascular aneurysm repair using unenhanced MRI with flow suppression technique: Feasibility study in comparison with contrast-enhanced CT

Abstract

Objectives

Methods

Results

Conclusions

Key points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key points

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