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Contrast-enhanced ultrasound (CEUS) versus computed tomography angiography (CTA) in detection of endoleaks in post-EVAR patients. Are delayed type II endoleaks being missed? A systematic review and meta-analysis

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Abstract

Purpose

The purpose of this systematic review is to assess the accuracy of contrast-enhanced ultrasound (CEUS) to computed tomography angiography (CTA) for the detection of endoleaks within EVAR surveillance program.

Material and methods

A systematic review in Pubmed, Embase and Cochrane database was performed. Articles assessing diagnostic accuracy and comparative modality (CTA vs. CEUS) for endoleaks in adult patients within surveillance programs were retrieved. Methodological assessment was performed, using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tools. The sensitivity and specificity of data were extracted and statistical analysis was performed using MetaDiSc version 1.4.

Results

Eight articles were found eligible (n = 454 patients). The pooled sensitivity of CEUS at detecting endoleak is 0.914 (CI 0.866–0.949) and pooled specificity is 0.782 (CI 0.741–0.820).

Conclusion

The CEUS with its dynamic nature and longer scanning window demonstrated to be a highly sensitive modality for endoleak detection in comparison to CTA in delayed endoleaks type II.

Riassunto

Scopo

Scopo di questa revisione è stato valutare l'accuratezza dell'ecografia con mezzo di contrasto (CEUS) rispetto all'Agio Tomografia Computerizzata (CTA) per il rilevamento di endoleak, nell'ambito del programma di sorveglianza EVAR.

Materiali e Metodi

E' stata eseguita una revisione sistematica nei database Pubmed, Embase e Cochrane. Sono stati valutati gli articoli che prendevano in considerazione l'accuratezza diagnostica e il confronto (CTA Vs CEUS) per endoleak, in pazienti adulti nell'ambito di programmi di sorveglianza. La valutazione metodologica è stata effettuata utilizzando come strumento il Quality Assessment of Diagnostic Accuracy Studiesla (QUADAS). Sono state estratte sensibilità e specificità ed è stata effettuata l'analisi statistica utilizzando MetaDiSc version 1.4.

Risultati

Sono stati trovati otto articoli adatti allo studio (n = 454 pazienti). La sensibilità della CEUS nell'individuare endoleak è 0,914 (CI 0,866-0,949) e la specificità 0,782 (CI 0,741-0,820).

Conclusione

La CEUS, per la sua natura dinamica e la possibilità di scansione più lunga, ha dimostrato di essere una modalità altamente sensibile per la rilevazione di endoleak rispetto alla CTA negli endoleak di tipo II.

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Conflict of interest

The authors (J. Chung, A. Kordzadeh, I. Prionidis, Y. Panayiotopoulos, T. Browne) have no conflict of interest.

Human and Animal Studies

The study described in this article does not contain studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Vascular and Endovascular Surgery, Mid Essex Hospital Services NHS Trust, Broomfield Hospital, Chelmsford, Essex, CM1 7ET, UK

    J. Chung, A. Kordzadeh, I. Prionidis, Y. Panayiotopoulos & T. Browne

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  1. J. Chung
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  2. A. Kordzadeh
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  3. I. Prionidis
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Correspondence to A. Kordzadeh.

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Chung, J., Kordzadeh, A., Prionidis, I. et al. Contrast-enhanced ultrasound (CEUS) versus computed tomography angiography (CTA) in detection of endoleaks in post-EVAR patients. Are delayed type II endoleaks being missed? A systematic review and meta-analysis. J Ultrasound 18, 91–99 (2015). https://doi.org/10.1007/s40477-014-0154-x

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  • DOI: https://doi.org/10.1007/s40477-014-0154-x

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