University Hospital Of Medicine France
Patricia Costa is a vascular doctor in University Hospital of Medicine in Besancon France. She has completed her medicine studies in Lyon University School of Medicine in hospital department of vascular and cardiac functional explorations where she published her first paper in reputed French vascular medicine journal ≪JournaldesMaladiesVasculaires≫ in December 2013. In her hospital department, she participated in numerous protocols of clinical research and she is in charge of teaching with the studets of medicine.
Objective Type II endoleaks (EFII) are related to retrograde flow via aorta tributaries. They are the most frequent complication after endovascular aneurysm repair (EVAR). We hypothesized that the use of contrast-enhanced ultrasound (CEUS) by an experienced vascular physician could increase the sensitivity of detecting EFII compared with computed tomography angiography (CTA) taken as the gold standard. Material and method From November 2010 to February 2013, patients with EVAR were included prospectively. All patients had a color duplex ultrasound (CDU), CEUS and CTA. Sensitivity, specificity and kappa's coefficient were determined to estimate the performance of CDU and CEUS to assess EFII compared with CTA. Results Sixty CDU and 60 CEUS explorations were compared to 60 CTA explorations. Nineteen type EFII were detected by CTA, 14 by CDU and 15 by CEUS. CDU sensitivity was 74% (κ = 0.75), and CEUS sensitivity was 78% (κ = 0.8). Both tests exhibited 97% specificity. There was good agreement between CDU results (κ = 0.75) and CEUS results (κ = 0.8) compared with CTA. There was very good agreement between CDU and CEUS results for detection of EFII (κ = 0.93). There was no statistically significant difference between the sensitivity of CDU and CEUS (P = 0.32). Conclusion Our results suggest that contrast enhancement does not increase yield for ultrasound detection of type II endoleaks when performed by an experienced vascular physician.