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

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.