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MRI Versus Helical CT for Endoleak Detection After Endovascular Aneurysm Repair

¹ Department of Radiology, University Hospital of Mainz, Langenbeckstrasse 1, Mainz 55131, Germany.
² Department of Cardiovascular Surgery, University Hospital of Mainz, Mainz, Germany.

View larger version (98K): [in a new window]   Fig. 1A —Type III endoleak from leakage of graft material at right limb of stent-graft in 81-year-old man. Contrast-enhanced T1-weighted 3D FLASH angiography (A, coronal) and T1-weighted 2D FLASH (B, axial) images clearly show endoleak. Using size categories, reviewers classified this endoleak as size B—that is, > 3% but 10% of aneurysm cross-sectional area.

View larger version (116K): [in a new window]   Fig. 1B —Type III endoleak from leakage of graft material at right limb of stent-graft in 81-year-old man. Contrast-enhanced T1-weighted 3D FLASH angiography (A, coronal) and T1-weighted 2D FLASH (B, axial) images clearly show endoleak. Using size categories, reviewers classified this endoleak as size B—that is, > 3% but 10% of aneurysm cross-sectional area.

View larger version (127K): [in a new window]   Fig. 1C —Type III endoleak from leakage of graft material at right limb of stent-graft in 81-year-old man. Endoleak was not detected on corresponding CT scans, neither arterial contrast phase (C) nor late-contrast phase (D) scan.

View larger version (134K): [in a new window]   Fig. 1D —Type III endoleak from leakage of graft material at right limb of stent-graft in 81-year-old man. Endoleak was not detected on corresponding CT scans, neither arterial contrast phase (C) nor late-contrast phase (D) scan.

View larger version (146K): [in a new window]   Fig. 2A —Type II endoleak-size A, 3% of cross-sectional aneurysm area in 76-year-old man. Endoleak is not detected on biphasic CT scans: arterial phase, A; late phase, B.

View larger version (155K): [in a new window]   Fig. 2B —Type II endoleak-size A, 3% of cross-sectional aneurysm area in 76-year-old man. Endoleak is not detected on biphasic CT scans: arterial phase, A; late phase, B.

View larger version (120K): [in a new window]   Fig. 2C —Type II endoleak-size A, 3% of cross-sectional aneurysm area in 76-year-old man. Contrast-enhanced MR image shows small endoleak (arrow) near ostia of lumbar arteries, indicating type II endoleak. Signal void (asterisk) in right limb of stent-graft is due to artifacts caused by stainless steel. Wallstent (Boston Scientific) had been implanted because of kinking and stenosis of right limb. However, signal void did not mean occlusion of limb (A and B). In contrast, patency of left limb is clearly visualized, and nitinol stent struts are clearly depicted, despite moderate artifacts of platinum markers (arrowhead) of connection site of stent-graft.

View larger version (135K): [in a new window]   Fig. 3A —Type II endoleak-size C, > 10% but 30% of cross-sectional aneurysm area in 71-year-old man. Endoleak is not visualized on biphasic scans: arterial phase, A; late phase, B.

View larger version (146K): [in a new window]   Fig. 3B —Type II endoleak-size C, > 10% but 30% of cross-sectional aneurysm area in 71-year-old man. Endoleak is not visualized on biphasic scans: arterial phase, A; late phase, B.

View larger version (128K): [in a new window]   Fig. 3C —Type II endoleak-size C, > 10% but 30% of cross-sectional aneurysm area in 71-year-old man. Contrast-enhanced MR image clearly shows endoleak (arrow) dorsal in aneurysm sac.

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