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Kontrastmittelverstärkter Ultraschall im Follow-up nach endovaskulärer Stentversorgung eines infrarenalen Bauchaortenaneurysmas

Imaging of endoleaks after endovascular aneurysm repair (EVAR) with contrast-enhanced ultrasound (CEUS)

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Zusammenfassung

Der Nachweis oder Ausschluss von Endoleaks nach endovaskulärer Aneurysmaoperation (EVAR) der infrarenalen Aorta stellt eine schwierige diagnostische Herausforderung dar. Die kontrastmittelverstärkte Sonographie (CEUS) ist eine neue und viel versprechende Methode für die Diagnose und die Verlaufskontrolle von Endoleaks. Die CEUS mit dem Kontrastmittel SonoVue® ermöglicht eine schnelle, nichtinvasive Diagnostik im Follow-up nach endovaskulärer Therapie des infrarenalen Bauchaortenaneurysmas. Sensitivität und Spezifität des konventionellen Ultraschalls im Vergleich zur Multislice-CT-Angiographie (MS-CTA) werden mit 33–63 bzw. 63–93% angegeben. Diese Werte können durch den Einsatz der CEUS auf 98–100% (Sensitivität) bzw. 82–93% (Spezifität) gesteigert werden. Dieser Beitrag beschreibt die Ätiologien, die Klassifikation und Bedeutung von Endoleaks und deren Auffindbarkeit mit Hilfe von CEUS.

Abstract

Endoleaks following endovascular aneurysm repair (EVAR) are common and present a diagnostic challenge in the follow-up after EVAR. Contrast-enhanced ultrasound (CEUS) is a promising new method for the diagnosis and follow-up of endoleaks. CEUS with SonoVue® allows a rapid and non-invasive diagnosis in the follow-up after EVAR. The sensitivity and specificity of conventional ultrasound compared to the multislice CT angiography is estimated to be 33–63% and 63–93%, respectively. These values can be increased through the use of CEUS in up to 98–100% (sensitivity) and 82–93% (specificity). This article describes the etiology, classification and importance of different types of endoleaks. The value of CEUS in this clinical scenario will be discussed.

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Authors and Affiliations

  1. Institut für Klinische Radiologie, Klinikum der Ludwig-Maximilians-Universität, Campus Grosshadern, Marchioninistr. 15, 81377, München, Deutschland

    D.-A. Clevert, A. Horng, W.H. Sommer & M. Reiser

  2. Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Städtisches Klinikum München, Klinikum München-Harlaching, München, Deutschland

    R. Kopp

  3. Chirurgische Klinik und Poliklinik, Klinikum der Ludwig-Maximilians-Universität, Campus Grosshadern, München, Deutschland

    K. Schick & G. Meimarakis

Authors
  1. D.-A. Clevert
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  2. A. Horng
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  3. R. Kopp
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  4. K. Schick
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  5. G. Meimarakis
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  6. W.H. Sommer
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  7. M. Reiser
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Correspondence to D.-A. Clevert.

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Clevert, DA., Horng, A., Kopp, R. et al. Kontrastmittelverstärkter Ultraschall im Follow-up nach endovaskulärer Stentversorgung eines infrarenalen Bauchaortenaneurysmas. Radiologe 49, 1033–1039 (2009). https://doi.org/10.1007/s00117-009-1876-1

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  • DOI: https://doi.org/10.1007/s00117-009-1876-1

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