The objective was to assess the diagnostic accuracy of microvascular flow imaging ultrasound (MVUS) for the detection of endoleak after endovascular aortic aneurysm repair. A systematic search of the literature published until January 2024 was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses of Diagnostic Test Accuracy (PRISMA-DTA) guidelines. The pooled rates of sensitivity, specificity, and diagnostic odds ratio of MVUS in endoleak detection with computed tomography angiography as the reference standard were estimated using univariate random-effect analysis with 95% confidence intervals. Three studies were considered eligible for inclusion. Superb micro vascular imaging (SMI) was used as an MVUS technique in all cases. The total number of paired scans was 209. Sensitivity and specificity of the individual studies ranged 0.75-1.00 and 0.93-1.00, respectively. Pooled sensitivity and specificity of the SMI method was 0.91 (CI: 0.82-0.96) and 0.98 (CI: 0.94-1.00), respectively. The pooled diagnostic odds ratio was 635 (95% CI: 128-3140). The findings of the present study support the use of the MVUS for endoleak detection. However, further research is warranted to explore the broader application of MVUS, providing a more comprehensive understanding and establishing robust criteria for its role in clinical practice.
The aim of the study was to assess patient selection for embolization of varicoceles based on ultrasonography. An additional objective of the work was to evaluate the results of endovascular treatment.From January 2015 till August 2017, 53 patients with varicoceles diagnosed in an ultrasound examination underwent endovascular treatment in the Department of Interventional Radiology and Neuroradiology in Lublin, Poland. Each ultrasound examination was performed using the Logiq 7 GE Medical System with a linear probe at 6-12 MHz using the B-mode and Doppler functions. The study was performed in both the supine and standing position of the patient. The morphological structures of the scrotum and the width of the pampiniform venous plexus were assessed. Based on clinical signs and symptoms as well as ultrasound findings, the patients were selected for endovascular treatment. This procedure involved the implantation of coils in the distal and proximal parts of the testicular vein and administration of a sclerosing agent between the coils.Varicoceles were confirmed in all patients during a color Doppler scan. Diagnostic venography confirmed venous stasis or retrograde flow in the testicular vein and widened vessels of the pampiniform venous plexus over 2 mm in diameter in all patients undergoing endovascular treatment. The diagnostic efficacy of ultrasound was 100%. The technical success of the procedure was 89%. One patient had a recurrence of varicose veins (2.2%). There were no complications in any of the patients.Ultrasound is the preferred method in the diagnosis of varicoceles and selection for their treatment. Testicular vein embolization is a minimally invasive procedure characterized by high efficacy and safety.
Introduction. The endovascular treatment of patient with abdominal aorta aneurysms has been a recognized alternative to classic surgery. One of the most common complications is an endoleak developing due to incomplete exclusion of the aneurysmal sac from circulation. Aim. To assess the value of ultrasound contrast agents for the diagnosis of endoleaks in patients with AAA treated by stent graft implantation. Material and methods. One hundred and ninety-eight patients with AAA were treated with stent graft implantation. Follow-up examinations, i.e. preand post-contrast ultrasound and angio-CT, were performed 6 months after treatment in all patients. In each ultrasound examination, colour, power, Bflow options were used before and after contrast injection; additionally, contrast-enhanced ultrasound (CEUS) was performed after contrast administration. Results. During the follow-up examinations after 6 months, pre-contrast ultrasound performed in all options (colour, power, Bflow) revealed 16 endoleaks: 6 type IA, 4 type IB, type 2 IIA and 4 type IIB; in post-contrast ultrasound using CEUS 22 endoleaks were confirmed and additionally 4 endoleaks were diagnosed: 2 type IIA, and 2 type IIB. In angio-CT, 22 endoleaks were diagnosed: 1 type IA, 5 type IB, 4 type IIA, and 7 type IIB. None of the four additional endoleaks observed with CEUS was found in angio-CT. Conclusions. The use of ultrasound contrast media significantly increases the sensitivity of ultrasound in the diagnosis of endoleaks, particularly type II ones. CEUS examinations show the greatest sensitivity in detecting endoleaks, as they disclose the endoleaks unrecognized by other techniques, including angio-CT. Post-contrast ultrasound can replace angio-CT in monitoring patients after stent graft implantations.
A 33-year-old male was admitted to local Nuclear Medicine Department with suspected femoral head necrosis.His chief complaint was pain located in left inguinal region exacerbating during walking.He was forced to use a crutch.Three-phase bone scan (TPBS) was performed according to the standard protocol used in our Department.99m Tc-labelled
