Coronary Artery Stent Patency Assessed with In-Stent Contrast Enhancement Measured at Multi–Detector Row CT Angiography: Initial Experience

Abstract

The authors investigated the contrast enhancement characteristics of the coronary artery stent lumen to assess patency and then evaluated the accuracy of computed tomographic (CT) measurement of the in-stent luminal diameter. Nineteen patients (16 men and three women; mean age, 58.7 years) with 26 stents underwent cardiac-gated CT angiography with a 16-detector row scanner 1-3 weeks after stent placement. CT images depicted the lumina of 20 stents in 14 patients. CT attenuation measured in the treated lumen was higher than, and correlated highly (r >/= 0.87) with, attenuation in the proximal and distal untreated lumen. Estimated values for in-stent luminal diameter were lower with CT than with conventional angiography (P <.001), and the mean error (16.1%) that resulted from estimation based on sharp-kernel CT images was significantly smaller than that (27.3%) from estimation based on medium-smooth-kernel CT images (P <.001). Visualization of the in-stent lumen at CT angiography with a 16-detector row scanner allows assessment of coronary artery stent patency on the basis of measured contrast enhancement.

Coronary Stent Artifact Reduction With an Edge-Enhancing Reconstruction Kernel - A Prospective Cross-Sectional Study With 256-Slice Ct

“…On the other hand, in vivo studies that quantitatively assessed the effect of CT kernels on coronary artery stent blooming artifacts are scarce [18][19][20]32]. Hong et al [18] and Seifarth et al [20] assessed artificial coronary stent lumen narrowing using 16-slice scanners and image reconstruction with both sharp (B46f) and medium-smooth (B30f) kernels.…”

“…In a 256-slice scanner study using a CT pixel attenuation profile method on 28 stents, Oda et al [19] measured less blooming artifacts with a sharp kernel (CD), in comparison to a soft (CB) kernel. Of note, the observers in the study of Cui et al [32] were blinded to the type of reconstruction kernel, in contrast to former studies [18][19][20]. However, in the study of Cui et al [32], stent blooming quantification was performed by comparing the stent inner diameter to the nominal stent diameter.…”

“…Only few in vivo studies have quantitatively evaluated the effect of CT kernels on coronary stent artifacts [18][19][20]. The objective of this clinical prospective 256-slice CT study is to provide an in vivo assessment of the effect of an edge-enhancing CT reconstruction kernel on the visualization of stent wall and lumen and on image quality scores as compared to a standard kernel.…”

Noninvasive Assessment of In-Stent Restenosis of the Coronary Artery with Using 16-Slice Computed Tomography

“…1). The ROI was consistently drawn along the inner border of the stent wall under a setting of 5,000 Hounsfield Units (HU) for the window width and a level of 200 HU to improve the delineation of the real stent size (12). We also measured the CT attenuation values on the cross-sectional view of the segments that were proximal to the stents; these segments had the largest area within a 2 cm distance from the stents and they were not combined with the stenosis, if possible.…”

Angiografia coronariana minimamente invasiva através de tomografia com múltiplos detectores

“…Nevertheless, in some cases, the contrast through the prosthesis could be adequately studied as well as its patency along with the degree of distal artery opacifi cation [29][30][31][32][33] .…”