Prospective, intraindividual comparison of MRI versus MDCT for endoleak detection after endovascular repair of abdominal aortic aneurysms

• Published in: European radiology Vol. 19; no. 5; pp. 1223 - 1231
• Main Authors: Alerci, Mario, Oberson, Michel, Fogliata, Antonella, Gallino, Augusto, Vock, Peter, Wyttenbach, Rolf
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.05.2009; Springer Nature B.V
• Subjects: Abdomen; Aged; Angina pectoris; Aortic Aneurysm, Abdominal - diagnostic imaging; Aortic Aneurysm, Abdominal - pathology; Aortic Aneurysm, Abdominal - surgery; Aortic aneurysms; Contrast agents; Contrast Media - pharmacology; Diagnostic Radiology; False Positive Reactions; Female; Humans; Image Processing, Computer-Assisted; Imaging; Internal Medicine; Interventional Radiology; Magnetic Resonance; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medical imaging; Medicine; Medicine & Public Health; Meglumine - analogs & derivatives; Meglumine - pharmacology; Middle Aged; Neuroradiology; Observer Variation; Organometallic Compounds - pharmacology; Patients; Prospective Studies; Radiology; Reproducibility of Results; Sensitivity and Specificity; Surveillance; Tomography; Tomography, X-Ray Computed - methods; Ultrasound; Switzerland; Computed tomography; Magnetic resonance imaging; Gadobenate dimeglumine; Endoleak; Aneurysm; Aorta; Endovascular repair
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-008-1253-x

This study compares MRI and MDCT for endoleak detection after endovascular repair of abdominal aortic aneurysms (EVAR). Forty-three patients with previous EVAR underwent both MRI (2D T1-FFE unenhanced and contrast-enhanced; 3D triphasic contrast-enhanced) and 16-slice MDCT (unenhanced and biphasic contrast-enhanced) within 1 week of each other for endoleak detection. MRI was performed by using a high-relaxivity contrast medium (gadobenate dimeglumine, MultiHance®). Two blinded, independent observers evaluated MRI and MDCT separately. Consensus reading of MRI and MDCT studies was defined as reference standard. Sensitivity, specificity, and accuracy were calculated and Cohen’s k statistics were used to estimate agreement between readers. Twenty endoleaks were detected in 18 patients at consensus reading (12 type II and 8 indeterminate endoleaks). Sensitivity, specificity, and accuracy for endoleak detection were 100%, 92%, and 96%, respectively, for reader 1 (95%, 81%, 87% for reader 2) for MRI and 55%, 100%, and 80% for reader 1 (60%, 100%, 82% for reader 2) for MDCT. Interobserver agreement was excellent for MDCT ( k  = 0.96) and good for MRI ( k  = 0.81). MRI with the use of a high-relaxivity contrast agent is significantly superior in the detection of endoleaks after EVAR compared with MDCT. MRI may therefore become the preferred technique for patient follow-up after EVAR.