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Helical CT of aorta after endoluminal stent-graft therapy: value of biphasic acquisition
J Golzarian1, L Dussaussois, H T Abada
1Department of Radiology, Erasme Hospital, University of Brussels, Belgium.
Insights
Biphasic helical CT effectively detects perigraft leakage after aortic stent-graft placement. This dual-phase imaging improves diagnostic accuracy compared to single-phase CT scans for evaluating endoluminal aortic repair.
Area of Science:
- Radiology
- Medical Imaging
- Cardiovascular Imaging
Background:
- Endoluminal stent-graft placement is a common treatment for aortic aneurysms.
- Post-procedure surveillance is crucial to detect complications such as endoleaks.
- Helical computed tomography (CT) is a primary imaging modality for aortic evaluation.
Purpose of the Study:
- To prospectively evaluate the diagnostic utility of biphasic helical CT for assessing the aorta after endoluminal stent-graft placement.
- To compare the effectiveness of biphasic helical CT with single-phase arterial acquisition in detecting perigraft leakage.
Main Methods:
- A prospective study involving 95 patients with abdominal and thoracic aortic aneurysms who underwent endoluminal stent-graft repair.
- Biphasic helical CT scans were acquired, including an arterial phase and a delayed phase (15 seconds later).
- Standardized scanning parameters were used for both phases: 5 mm collimation, 7 mm/rotation table speed, 0.75 sec rotation time, 120 kV, and 295 mA.
Main Results:
- Perigraft leakage was identified in 45 (47%) of 95 patients.
- Leakage was detected exclusively on the arterial phase in 8 patients and exclusively on the delayed phase in 3 patients.
- Biphasic acquisition demonstrated superiority over arterial phase acquisition alone in 15 (16%) of patients for detecting leakage and outflow vessels.
Conclusions:
- Biphasic helical CT offers superior diagnostic value compared to arterial phase acquisition alone for evaluating the aorta post-endoluminal stent-graft therapy.
- The dual-phase approach enhances the detection of perigraft endoleaks, improving surveillance accuracy.
- This technique is valuable for comprehensive assessment of endovascular aortic repair outcomes.
Objective:
We report our prospective study evaluating biphasic helical CT of the aorta after endoluminal stent-graft placement.
Subjects And Methods:
Biphasic helical CT scans in 95 patients with abdominal and thoracic aortic aneurysms who had undergone endoluminal stent-graft placement were reviewed. After a test bolus injection of 15 ml of contrast media at a rate of 3.5 ml/sec for the measurement of the optimal start delay, the aorta was scanned using the following parameters: collimation of 5 mm, table speed of 7 mm per rotation, tube rotation time of 0.75 sec, 120 kV, and 295 mA. A delayed helical CT scan was obtained 15 sec after the initial acquisition using the same parameters.
Results:
Biphasic helical CT scans showed perigraft leakage in 45 (47%) of 95 patients. Leakage was shown only on arterial phase CT in eight patients and only on the delayed scans in three patients. In two patients, leakage shown on the delayed acquisition was retrospectively seen on the first scan. Leakage and outflow vessels were most visible on the arterial phase acquisition in 17 patients and on the second acquisition in six patients. Overall, biphasic acquisition was superior to arterial phase acquisition alone in 15 (16%) of 95 patients.
Conclusion:
The diagnostic value of biphasic helical CT is superior to arterial phase acquisition alone for the evaluation of the aorta after endoluminal stent-graft therapy.
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