Detection of Occult Endoleaks After Endovascular Treatment of Abdominal Aortic Aneurysm Using Magnetic Resonance Imaging With a Blood Pool Contrast Agent

Abstract

Endoleaks that are occult on CT can be detected by MRI with blood pool contrast agents. Late phase MRI 30 minutes after injection revealed additional endoleaks not seen 3 minutes after injection.

Impact of Age and Intraluminal Thrombus Volume on Abdominal Aortic Aneurysm Sac Enlargement after Endovascular Repair

“…In patients without apparent type II endoleak, occult type I and III endoleaks may be implicit, and further evaluation will be required. 17,18 On the other hand, anticoagulation therapy was reported to be a risk for residual endoleak and sac expansion. 19,20 However, some recent studies including this study demonstrated that warfarin therapy was not associated with increased incidence of endoleaks and sac enlargement.…”

Magnetic Resonance Imaging with a Weak Albumin Binding Contrast Agent can Reveal Additional Endoleaks in Patients with an Enlarging Aneurysm after EVAR

“…In 16 of 24 (67%) patients an additional endoleak was detected, mainly type II caused by lumbar feeding arteries. The detection of these occult endoleaks is clinically 10 Cornelissen et al discussed 12 patients with non-shrinking aneurysms after EVAR and no evidence of endoleak on CTA. 10 In six of 11 (55%) patients additional endoleaks were detected by MRI using the strong albumin binding contrast agent gadofosveset trisodium (Ablavar; Lantheus Medical Imaging, Billerica, MA, USA).…”

“…The detection of these occult endoleaks is clinically 10 Cornelissen et al discussed 12 patients with non-shrinking aneurysms after EVAR and no evidence of endoleak on CTA. 10 In six of 11 (55%) patients additional endoleaks were detected by MRI using the strong albumin binding contrast agent gadofosveset trisodium (Ablavar; Lantheus Medical Imaging, Billerica, MA, USA). 10 As this contrast agent is available exclusively in the USA, the aim of the present study was to investigate the value of another albumin binding contrast agent.…”

“…The presence of endoleak was defined as a high intensity signal inside the aneurysm sac on postcontrast images not present on pre-contrast images. 10 The identification of post-contrast high signal intensity dorsally (lumbar type II endoleak) and ventrally (inferior mesenteric artery [IMA] type II endoleak) in direct connection with the aneurysm sac indicates the presence of a type II endoleak. Furthermore, the presence of prominent lumbar arteries and/or IMA around the high signal also strengthens the suspected presence of a type II endoleak.…”

Endoleak detection after endovascular aneurysm repair using unenhanced MRI with flow suppression technique: Feasibility study in comparison with contrast-enhanced CT

“…Recently, gadofosveset has been reported as a promising blood pool contrast agent for detecting endoleaks [13,14], though it also contains gadolinium. Superparamagnetic iron oxide (SPIO)-enhanced MR imaging was reported as another method to detect endoleaks without using gadolinium [15]; however, SPIO was developed for liver imaging; thus, its use following EVAR is off-label at this time.…”