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European Radiology

, Volume 19, Issue 5, pp 1223–1231 | Cite as

Prospective, intraindividual comparison of MRI versus MDCT for endoleak detection after endovascular repair of abdominal aortic aneurysms

  • Mario Alerci
  • Michel Oberson
  • Antonella Fogliata
  • Augusto Gallino
  • Peter Vock
  • Rolf WyttenbachEmail author
Magnetic Resonance

Abstract

This study compares MRI and MDCT for endoleak detection after endovascular repair of abdominal aortic aneurysms (EVAR). Forty-three patients with previous EVAR underwent both MRI (2D T1-FFE unenhanced and contrast-enhanced; 3D triphasic contrast-enhanced) and 16-slice MDCT (unenhanced and biphasic contrast-enhanced) within 1 week of each other for endoleak detection. MRI was performed by using a high-relaxivity contrast medium (gadobenate dimeglumine, MultiHance®). Two blinded, independent observers evaluated MRI and MDCT separately. Consensus reading of MRI and MDCT studies was defined as reference standard. Sensitivity, specificity, and accuracy were calculated and Cohen’s k statistics were used to estimate agreement between readers. Twenty endoleaks were detected in 18 patients at consensus reading (12 type II and 8 indeterminate endoleaks). Sensitivity, specificity, and accuracy for endoleak detection were 100%, 92%, and 96%, respectively, for reader 1 (95%, 81%, 87% for reader 2) for MRI and 55%, 100%, and 80% for reader 1 (60%, 100%, 82% for reader 2) for MDCT. Interobserver agreement was excellent for MDCT (k = 0.96) and good for MRI (k = 0.81). MRI with the use of a high-relaxivity contrast agent is significantly superior in the detection of endoleaks after EVAR compared with MDCT. MRI may therefore become the preferred technique for patient follow-up after EVAR.

Keywords

Aneurysm Aorta Endovascular repair Endoleak Computed tomography Magnetic resonance imaging Gadobenate dimeglumine 

Abbreviations

MDCT

multidetector computed tomography

MRI

magnetic resonance imaging

EL

endoleak(s)

EVAR

endovascular aortic aneurysm repair

MRA

magnetic resonance angiography

MPR

multiplanar reconstruction

MIP

maximum-intensity projection

CI

confidence interval

Notes

Acknowledgments

Rolf Wyttenbach, MD, is supported by a grant from the Swiss Heart Foundation. We thank Paolo Santini, RT, and the team of MRI technicians for their collaboration and support.

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Copyright information

© European Society of Radiology 2008

Authors and Affiliations

  • Mario Alerci
    • 1
  • Michel Oberson
    • 2
  • Antonella Fogliata
    • 3
  • Augusto Gallino
    • 2
  • Peter Vock
    • 4
  • Rolf Wyttenbach
    • 1
    Email author
  1. 1.Department of RadiologyOspedale San Giovanni Bellinzona (EOC)BellinzonaSwitzerland
  2. 2.Department of CardiologyOspedale San Giovanni Bellinzona (EOC)BellinzonaSwitzerland
  3. 3.Department of Medical PhysicsOspedale San Giovanni Bellinzona (EOC)BellinzonaSwitzerland
  4. 4.Department of RadiologyInselspital, University of BerneBerneSwitzerland

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