Color Doppler Ultrasound with Superb Microvascular Imaging Compared to Contrast-enhanced Ultrasound and Computed Tomography Angiography to Identify and Classify Endoleaks in Patients Undergoing EVAR

Cantisani, Vito; David, Emanuele; Ferrari, Donatella; Fanelli, Fabrizio; Marzo, Luca di; Catalano, Carlo; Benedetto, Filippo; Spinelli, Domenico; Katsargyris, Αthanasios; Blandino, Alfredo; Ascenti, Giorgio; Dambrosio, F

doi:10.1016/j.avsg.2016.06.038

Cited by 42 publications

(30 citation statements)

References 39 publications

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“…From our standpoint, SMI appears to be an extremely robust and reliable technique in the setting of neonatal ultrasound. Since initial reports in March 2016 [14], SMI has been mainly used in oncologic conditions (especially breast lesions) [22–26], infectious diseases [16, 27, 28], gastrointestinal disorders [29–32], obstetric ultrasound [33, 34], musculoskeletal [35], vascular [36], and endocrine disorders [14]. In paediatric imaging, SMI has been used to detect direction of urinary flow in patients with vesico-urethral reflux without the use of contrast [16] and to demonstrate differences in vascular flow grades between normal and undescended testes, which were invisible by Power Doppler [17, 18].…”

Section: Discussionmentioning

confidence: 99%

Microvessel ultrasound of neonatal brain parenchyma: feasibility, reproducibility, and normal imaging features by superb microvascular imaging (SMI)

et al. 2018

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ObjectivesTo evaluate the feasibility and reproducibility of superb microvascular imaging (SMI) of the neonatal brain and to describe normal imaging features.MethodsWe performed transcranial ultrasound with SMI in 19 healthy term-born neonates. SMI was done according to a structured examination protocol, using two linear 18 MHz and 14 MHz transducers. Superficial and deep scans were acquired in the coronal and sagittal planes, using the left and right superior frontal gyri as anatomical landmarks. All SMI views were imaged by monochrome and colour SMI and evaluated with respect to visibility of extrastriatal (i.e. cortical and medullary) and striatal microvessels.ResultsWe have described normal morphologic features of intraparenchymal brain microvasculature as “short parallel” cortical vessels, “smoothly curved” medullary vessels, and deep striatal vessels. In general, SMI performance was better on coronal views than on sagittal views. On superficial coronal scans, cortical microvessels were identifiable in 90–100%, medullary microvessels in 95–100%. On deep scans, cortical and medullary microvessels were visible in all cases, while striatal microvessels were identifiable in 71% of cases.ConclusionsCerebral SMI ultrasound is feasible and well-reproducible and provides a novel non-invasive imaging tool for the assessment of intraparenchymal brain microvasculature (extrastriatal and striatal microvessels) in neonates without the use of contrast.Key Points• Superb microvascular imaging (SMI) of the neonatal brain is feasible and reproducible. • SMI depicts extrastriatal and striatal microvessels. • SMI detects two types of extrastriatal microvessels: cortical and medullary.Electronic supplementary materialThe online version of this article (10.1007/s00330-018-5743-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Microvessel ultrasound of neonatal brain parenchyma: feasibility, reproducibility, and normal imaging features by superb microvascular imaging (SMI)

et al. 2018

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“…While conventional techniques-such as applying a wall filter to remove clutter and motion artefacts-result in the loss of low-velocity blood flow signals, the superb microvascular system (SMI) of Toshiba Medical Systems uses a unique algorithm which differentiates 'actual' blood flow from artefacts, therefore preserving the subtlest vascular details [4]. SMI has proven to be effective in different clinical settings-it identifies micro-vascular signals in thyroid nodules [5], the vascularity of breast tumours [6], and endoleaks following endovascular aortic procedures [7].…”

mentioning

confidence: 99%

Superb microvascular imaging: a potential tool in the detection of FNH

Bonacchi¹,

Becciolini²,

Seghieri

2017

J Ultrasound

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“…According to the results, SMI was more accurate than CDUS, but less accurate than CEUS and CTA in identifying endoleaks. This led the authors to recommend SMI for post-EVAR follow-up, especially in cases when CEUS or CTA cannot be used [26]. The difference in the number of endoleaks reported by Cantisani et al and our study may influence the difference in sensitivity in both studies (75% vs. 100%, respectively).…”

Section: Discussionmentioning

confidence: 63%

Superb Micro-vascular Imaging (SMI): a Doppler ultrasound technique with potential to identify, classify, and follow up endoleaks in patients after Endovascular Aneurysm Repair (EVAR)

et al. 2018

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PurposeThe aim of the study was to assess the effectiveness of Superb Micro-vascular Imaging (SMI) as an alternative to Contrast-Enhanced Ultrasound (CEUS) and Computed Tomography Angiography (CTA) for endoleak detection and classification in patients followed up after endovascular abdominal aortic aneurysm repair (EVAR).Materials and methodsFrom May 2015 to January 2017, 30 patients underwent post-EVAR follow-up with Color Doppler Ultrasound (CDUS), CEUS, SMI, and CTA examinations. Aneurysmal sac diameter and graft patency were evaluated; endoleaks were identified and classified. Sensitivity, specificity, and accuracy values were calculated for each of the four diagnostic methods of endoleak detection. A percentage of agreement and Cohen’s Kappa coefficient were calculated for comparison of methods in terms of endoleak identification.ResultsCTA revealed fifteen endoleaks (50%): three type Ia, nine type II, and three type III. The sensitivity of CDUS, CEUS, and SMI relative to CTA was 27%, 100%, and 100%, respectively. Specificity was 93%, 93%, and 93%, respectively. Accuracy was 60%, 97%, and 97%, respectively. There were no differences between SMI and CEUS in terms of sensitivity, specificity, or accuracy (100%, 93%, and 97%). We do not observe statistically significant differences between CTA, CEUS, and SMI concerning endoleak identification ability. The weakest method in endoleak identification was CDUS.ConclusionsThe analysis showed that SMI is effective, repeatable, and comparable with the CEUS modality in identification endoleaks after EVAR; it may be considered as a potential tool to monitor patients after EVAR implantation, especially those with renal insufficiency or with an allergy to any contrast media.

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Color Doppler Ultrasound with Superb Microvascular Imaging Compared to Contrast-enhanced Ultrasound and Computed Tomography Angiography to Identify and Classify Endoleaks in Patients Undergoing EVAR

Cited by 42 publications

References 39 publications

Microvessel ultrasound of neonatal brain parenchyma: feasibility, reproducibility, and normal imaging features by superb microvascular imaging (SMI)

Microvessel ultrasound of neonatal brain parenchyma: feasibility, reproducibility, and normal imaging features by superb microvascular imaging (SMI)

Superb microvascular imaging: a potential tool in the detection of FNH

Superb Micro-vascular Imaging (SMI): a Doppler ultrasound technique with potential to identify, classify, and follow up endoleaks in patients after Endovascular Aneurysm Repair (EVAR)

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