Clinical Evaluation of Non-Contrast-Enhanced Radial Quiescent-Interval Slice-Selective (QISS) Magnetic Resonance Angiography in Comparison to Contrast-Enhanced Computed Tomography Angiography for the Evaluation of Endoleaks after Abdominal Endovascular Aneurysm Repair.

Autor: Mostafa K; Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel University, 24105 Kiel, Germany., Pfarr J; Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel University, 24105 Kiel, Germany., Langguth P; Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel University, 24105 Kiel, Germany., Schäfer JP; Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel University, 24105 Kiel, Germany., Trentmann J; Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel University, 24105 Kiel, Germany., Koktzoglou I; Department of Radiology, NorthShore University Health System, Evanston, IL 60201, USA.; Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA., Edelman RR; Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA.; Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA., Bueno Neves F; Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel University, 24105 Kiel, Germany., Graessner J; Siemens Healthcare GmbH, 20910 Hamburg, Germany., Both M; Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel University, 24105 Kiel, Germany., Jansen O; Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel University, 24105 Kiel, Germany., Salehi Ravesh M; Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel University, 24105 Kiel, Germany.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2022 Nov 04; Vol. 11 (21). Date of Electronic Publication: 2022 Nov 04.
DOI: 10.3390/jcm11216551
Abstrakt: Purpose: Contrast-enhanced (CE) angiographic techniques, such as computed tomographic angiography (CE-CTA), are most commonly used for follow-up imaging after endovascular aneurysm repair. In this study, CE-CTA and non-CE QISS-MRA were compared for the first time for assessing endoleaks and aneurysms at follow-up after abdominal EVAR.
Methods: Our study included 20 patients (17 male, median age 79.8 years) who underwent radial QISS-MRA and CE-CTA after EVAR at their first follow-up examination. Two interventional radiologists evaluated datasets from both techniques in each patient concerning presence of endoleaks, types of endoleaks, aneurysm diameter, and image quality. Interobserver and intermodal agreement were assessed with Cohen's Kappa.
Results: Image quality was rated as excellent or good for both modalities by both observers. Ferromagnetic embolization materials cause hyperdense artifacts in CE-CTA causing aneurysm sac diameter measurements to be inaccurate by up to 1 cm. Type 2 endoleaks with low-flow characteristics in CE-CTA were overlooked compared to radial QISS-MRA. Compared to CE-CTA, all endoleaks after abdominal EVAR were detected and classified correctly on QISS-MRA. The interobserver agreement between CE-CTA and QISS-MRA was almost perfect, except for type 2 endoleaks, where agreement was substantial. Intermodal aneurysm diameter correlate "very strongly" for both observers.
Conclusions: Radial QISS-MRA is a contrast agent free technique for diagnosing and monitoring all types of endoleaks and aneurysms in patients after abdominal EVAR. It provides information about specific clinical questions concerning aneurysm diameter and presence and types of endoleaks without radiation exposure and the side effects associated with iodine-based contrast agents.
Competing Interests: R.R.E. and I.K. receive research support from Siemens Healthineers. R.R.E. receives royalties from Siemens Healthineers. The remaining authors declare that they have no conflicts of interest.
Databáze: MEDLINE
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