超声造影诊断腹主动脉瘤腔内隔绝术后Ⅰ、Ⅱ型内漏的价值

The value of contrast enhanced ultrasound in diagnosing type I and II endoleaks after endovascular abdominalaortic aneurysm repair

目的探讨超声造影诊断腹主动脉瘤腔内隔绝术（EVAR）后Ⅰ、Ⅱ型内漏的价值。方法选取符合人组标准的EVAR术后随访患者接受超声造影、CT血管成像（cTA）检查。观察内容包括是否出现内漏、内漏位置、来源、支架型血管及内漏超声造影剂显影时间。分析不同分型内漏的超声造影特点。结果9例患者符合人组标准，接受了超声造影检查，均发现内漏，其中Ⅰ型内漏3例，Ⅱ型6例。6例Ⅱ型内漏超声造影剂显影时间晚于支架型血管9．8s（6～21s）。超声造影诊断结果与CTA一致。结论超声造影对EVAR术后Ⅰ及Ⅱ型内漏的诊断具有一定的价值，合理选择适应证可作为cTA的有益补充。

Objective To investigate the role of contrast enhanced ultrasound （CEUS） in detecting type I and Ⅱ endoleaks after endovascular abdominal aortic aneurysm repair （EVAR）. Methods Post- EVAR patients who met the inclusion criteria were enrolled. All of patients underwent CEUS and computer tomography angiography （CTA） examination. The following parameters were evaluated： ultrasound contrast agent within aneurysmal sac, location and source of endoleaks, wash-in time of endoleaks and stent- graft since contrast agent injection. Analysis was performed to observe different types of endoleak features in CEUS. Results Nine cases were enrolled and all the cases had endoleaks. Three cases were type I , 6 cases were type Ⅱ . The wash-in time of type Ⅱ endoleaks delayed 9.8 seconds compared to type I , and the results of CEUS diagnosis were consistent with CTA. Conclusions CEUS is an effective way to detect endoleaks. This technique can be used as a supplement for CTA in follow-up of post EVAR patients.