Prospective comparative analysis of colour-Doppler ultrasound, contrast-enhanced ultrasound, computed tomography and magnetic resonance in detecting endoleak after endovascular abdominal aortic aneurysm repair

Eur J Vasc Endovasc Surg. 2011 Feb;41(2):186-92. doi: 10.1016/j.ejvs.2010.10.003. Epub 2010 Nov 20.


Objectives: To assess the accuracy of colour-Doppler ultrasound (CDUS), contrast-enhanced ultrasonography (CEUS), computed tomography angiography (CTA) and magnetic resonance angiography (MRA) in detecting endoleaks after endovascular abdominal aortic aneurysm repair (EVAR).

Design: Prospective, observational study.

Materials and methods: From December 2007 to April 2009, 108 consecutive patients who underwent EVAR were evaluated with CDUS, CEUS, CTA and MRA as well as angiography, if further treatment was necessary. Sensitivity, specificity, accuracy and negative predictive value of ultrasound examinations were compared with CTA and MRA as the reference standards, or with angiography when available.

Results: Twenty-four endoleaks (22%, type II: 22 cases, type III: two cases) were documented. Sensitivity and specificity of CDUS, CEUS, CTA, and MRA were 58% and 93%, 96% and 100%, 83% and 100% and 96% and 100% respectively. CEUS allowed better classification of endoleaks in 10, two and one patients compared with CDUS, CTA and MRA, respectively.

Conclusions: The accuracy of CEUS in detecting endoleaks after EVAR is markedly better than CDUS and is similar to CTA and MRA. CEUS seems to be a feasible tool in the long-term surveillance after EVAR, and it may better classify endoleaks missed by other imaging techniques.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Angiography, Digital Subtraction
  • Aortic Aneurysm, Abdominal / surgery*
  • Aortography / methods*
  • Blood Vessel Prosthesis Implantation / adverse effects
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Blood Vessel Prosthesis*
  • Contrast Media*
  • Endoleak / diagnosis*
  • Endoleak / diagnostic imaging
  • Endoleak / etiology
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation*
  • Female
  • Humans
  • Italy
  • Magnetic Resonance Angiography*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • Prosthesis Design
  • Prosthesis Failure*
  • Sensitivity and Specificity
  • Stents*
  • Time Factors
  • Tomography, X-Ray Computed*
  • Ultrasonography, Doppler, Color*


  • Contrast Media