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Purpose: To compare compression elastography and contrast enhanced ultrasound in the follow-up after endovascular aortic aneurysm repair., Material and Methods: In this retrospective study a cohort of 33 patients with both CEUS and elastography follow-up examinations after EVAR were included. The examinations were done with a Siemens S 2000 with curved array 4 MHz multi-frequency transducer., Results: Regarding our inclusion and exclusion criteria we obtained 33 patients. CEUS was used as the preferred examination in determining the presence of an endoleak. The true positive rate for the detection of Endoleaks with compression elastography was 42.4% (14/33), the false positive rate was 12.1% (4/33), the true negative rate was 15.2% (5/33) and the false negative rate was 30.3% (10/33). The sensitivity of compression elastography was therefore 58.3% and the specifity was 55.6%. Kappa coefficient was 0.115., Conclusion: Compression elastography does not seem to have any additional advantages in the detection and classification of endoleaks in comparison to CEUS.

Purpose: To evaluate the additional effect of higher frequent linear probes than 12.5 MHz in color Doppler sonography and free hand sonoelastography of benign and malignant breast masses and to compare different color encodings in sonoelastography., Materials and Methods: From December 2012 to March 2013, 37 patients with benign or malignant breast masses were prospectively included in this study. All solid masses have been histologically proven. Two readers assessed sonoelastographic findings at 12.5 MHz vs. 17 MHz according to the tsukuba elasticity score and additionally different color encodings were compared. Results of Doppler sonography using a score of 0, 1 or 2, depending on the degree of perfusion, also were assessed at 12.5 MHz vs. 17 MHz., Results: Among the 37 examined breast masses there were 10 cysts, 16 fibroadenomas and 11 carcinomas. Median participant age was 49.0 years. Use of color Doppler sonography enabled to distinguish cysts from solid breast masses (p < 0.001), without an improvement at 17 MHz. Additional sonoelastography significantly improved the specificity in solid breast masses (p < 0.001). No changes could be seen using different colors in sonoelastography., Conclusion: Combination of color Doppler sonography and sonoelastography can increase the accuracy in distinguishing benign from malignant breast masses. The use of linear probes with a higher frequency than 12.5 MHz does not show any benefit, neither in color Doppler sonography nor in sonoelastography.

Background: This study compared contrast-enhanced ultrasound (CEUS) imaging and multislice computed tomography (MS-CT) angiography in detecting and classifying endoleaks in the follow-up of patients after endovascular aneurysm repair (EVAR)., Methods: This retrospective study consisted of 171 patients with CEUS imaging and MS-CT angiography follow-up examinations after EVAR. During follow-up, 489 CEUS and 421 MS-CT examinations were assessed. B-scan, color Doppler, and CEUS imaging were performed in all patients. MS-CT was performed with a 16-slice up to 128-slice scanner., Results: From the 132 patients in our cohort, we obtained 200 contemporary imaging examination pairs. MS-CT was used as the preferred examination in determining the presence of an endoleak. The true-positive rate for the detection of endoleaks with CEUS imaging was 42% (84 of 200), the false-positive rate was 4% (8 of 200), the true-negative rate was 52% (105 of 200), and the false-negative rate was 2% (3 of 200). The sensitivity of CEUS imaging was therefore 97%, and the specificity was 93%. The McNemar test value was 0.227, and the κ coefficient was 0.889., Conclusions: CEUS imaging appears to be as good as MS-CT angiography in the detection of endoleaks in the follow-up after EVAR, with the added advantages of no radiation dose and no nephrotoxicity of the contrast agents. A switch of the preferred examination from MS-CT to CEUS imaging should be considered., (Copyright © 2013 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.)

Purpose: To evaluate the feasibility of the classification of endoleaks following endovascular aortic aneurysm repair using the time-to-peak of the contrast agent in CEUS examinations., Material and Methods: In this retrospective study, a cohort of 171 patients with a total of 489 CEUS follow-up examinations after EVAR were included. In 254 of the 489 examinations, an endoleak was seen and the time-to-peak was measured in seconds. Existence of an endoleak was confirmed by CT as the gold standard., Results: We evaluated 254 CEUS video sequences showing an endoleak out of a total of 489 examinations. Kruskal-Wallis test revealed with p = 0.001 differences between the single endoleak types based on the time to peak. Correction after Bonferroni showed significant differences between type Ia compared to Ib and to IIa over inferior mesenteric artery (IMA) and IIa over lumbar artery (LA). There are also disparities between type Ib and type IIa IMA and type III, furthermore between type IIa IMA compared to IIa LA and type III as well as type IIa LA matched to type III., Conclusion: CEUS is an important method for the follow-up after EVAR. The time-to-peak does not seem to be a useful additional feature in classifying endoleaks, although there are differences between the time-to-peak of the single endoleak types and it is possible to make an order of the different endoleak types referring to the mean values.