La radiologia medica

, Volume 123, Issue 12, pp 904–909 | Cite as

CEUS versus CT Angiography in the follow-up of abdominal aortic endoprostheses: diagnostic accuracy and activity-based cost analysis

  • Niccolo’ Faccioli
  • Giovanni Foti
  • Giulia Casagranda
  • Elena Santi
  • Mirko D’Onofrio



To evaluate diagnostic accuracy and to perform an activity-based cost analysis of contrast-enhanced ultrasonography (CEUS) compared to computed tomography (CT) during annual surveillance after abdominal aortic aneurysm repair with endovascular procedure (EVAR).

Materials and methods

This retrospective study included 137 patients in post-EVAR follow-up over a 6-year period (average post-operatory follow-up without aneurysm sac volumetric reduction). Sensitivity, specificity, positive predictive values, negative predictive values and accuracy were considered for CEUS using CT angiography (CTA) as reference standard. An activity-based cost analysis was performed to evaluate potential savings due to the introduction of CEUS as an alternative to CT, after the first year of postoperative negative controls.


CEUS reported accuracy, sensitivity, specificity, positive predictive values, negative predictive values of 97.4, 96, 100, 100 and 93.1% in the detection and characterization of endoleaks. CEUS cost was € 84.7, and CTA cost was € 157.77, with a differential cost of € 73.07; using CEUS as an alternative to CT allowed a potential saving of 50.052,95 € during follow-up.


CEUS is an accurate and cheap imaging method in post-EVAR follow-up patients, and it could be considered as a valid alternative to CTA, after the first year of negative controls, reducing the number of unnecessary CT examinations.


EVAR CEUS CT angiography Endoleak Cost analysis 


Compliance with ethical standards

Conflict of Interest

All the authors declare that he/she has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent for CEUS, CT and MR was obtained from all individual participants included in the study. This single-center retrospective study received IRB approval.


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Copyright information

© Italian Society of Medical Radiology 2018

Authors and Affiliations

  • Niccolo’ Faccioli
    • 1
  • Giovanni Foti
    • 1
  • Giulia Casagranda
    • 1
  • Elena Santi
    • 1
  • Mirko D’Onofrio
    • 1
  1. 1.Department of RadiologyUniversity of VeronaVeronaItaly

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