Computed tomography angiography in abdominal aortic endoleaks: what is the optimal protocol?
John M Kirby1, Kartik S Jhaveri, John R Kachura
1Department of Medical Imaging, University Health Network and Mount Sinai Hospital, University of Toronto, Toronto, ON.
Objective:
To evaluate the roles of noncontrast and delayed phases of computed tomography angiography (CTA) for optimization of the CTA protocol in endoleak detection.
Methods:
CTAs of patients who underwent abdominal aortic endovascular stent-graft placement were retrospectively reviewed. CTA comprised noncontrast, arterial, and delayed phase (2 minutes postcontrast). The arterial phase was compared with a combined arterial and delayed phase and followed by the noncontrast phase to see whether additional information was obtained.
Results:
Thirty-eight CTA studies demonstrated endoleak. In 30 studies (79%; 95%CI 64% to 89%), endoleak was detected in the arterial phase. Eight studies (21%; 95%CI 11% to 36%) demonstrated an endoleak only in the delayed phase. No additional information was obtained in the noncontrast phase when compared with a combined reading of the arterial and delayed phases (95%CI 0% to 9%).
Conclusion:
Delayed-phase imaging is necessary for endoleak detection and obviates a noncontrast phase. Identical parameters should be used for arterial and delayed phases.
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