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    超声造影在腹主动脉瘤腔内修复术后内漏诊断中的价值研究

    Value of contrast-enhanced ultrasound in the diagnosis of internal leakage after endovascular aneurysm repair

      摘要
    • 摘要: 目的：探讨超声造影（CEUS）在腹主动脉瘤腔内修复术（EVAR）后内漏诊断中的临床应用价值。方法：选取2020年1月至2022 年10 月在本院行EVAR 的腹主动脉瘤（AAA）患者93 例，所有患者均进行CEUS 及CT 血管成像（CTA）检查，分析对照两项检查对内漏及内漏分型的诊断结果，应用Kappa分析法评价两者的一致性。结果：93例患者中，CTA提示无内漏70例，发生内漏23 例，其中I型3 例，Ⅱ型16 例，Ⅲ型4 例；CEUS 提示无内漏72 例，发生内漏21 例，其中I型5 例，Ⅱ型14 例，Ⅲ型2例。CEUS诊断术后内漏总体符合率95.69%，灵敏度为86.95%，特异度为98.57%，阳性预测值95.23%，阴性预测值95.83%，与CTA 诊断结果的一致性Kappa 值为0.881（P＜0.001）。CEUS 对23 例内漏患者分型的总体符合率为73.91%，与CTA 诊断结果的一致性Kappa值为0.516（P＜0.001）。结论：CEUS在EVAR术后内漏诊断中具有较高的应用价值，可作为EVAR术后随访的有效检查手段。

       

      Abstract: Objective: To investigate the clinical value of contrast-enhanced ultrasound(CEUS)in the diagnosis of internal leakage after endovascular aneurysm repair (EVAR).Methods: Ninety-three abdominal aortic aneurysm (AAA) patients who received EVAR in our hospital from January 2020 to October 2022 were selected.All patients were examined by CEUS and CT angiography (CTA).The diagnosis results of internal leakage and classification of internal leakage were analyzed and compared and Kappa analysis was used to evaluate the consistency of the two examinations.Results: Among 93 patients, CTA showed no internal leakage in 70 cases, and internal leakage occurred in 23 cases, including 3 cases of type I, 16 cases of type II, and 4 cases of type III; CEUS showed no internal leakage in 72 cases, and internal leakage occurred in 21 cases, including 5 cases of type I, 14 cases of type II, and 2 cases of type III.The overall coincidence rate of internal leakage after CEUS diagnosis was 95.69%, the sensitivity was 86.95%, the specificity was 98.57%, the positive predictive value was 95.23%, the negative predictive value was 95.83%, and the Kappa value of consistency with CTA diagnosis was 0.881(P＜0.001).The overall coincidence rate of the classification of internal leakage after CEUS in 23 patients was 73.91%, and the Kappa value of consistency with CTA diagnosis was 0.516 (P＜0.001).Conclusion: CEUS has a high application value in the diagnosis of internal leakage after EVAR surgery, and can be used as an effective means of follow-up.

       

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