Coronary Artery Stents in Multislice Computed Tomography: In Vitro Artifact Evaluation

Rationale and ObjectiveThe aim of this study was to systematically compare the ability to assess the coronary artery lumen in the presence of coronary artery stents in multislice spiral CT (MSCT). MethodsTen different coronary artery stents were examined with 4- and 16-detector row MSCT scanners. For image reconstruction, a standard and a dedicated convolution kernel for coronary artery stent visualization were used. Images were analyzed regarding lumen visibility, intraluminal attenuation, and artifacts outside the stent lumen. Results were compared using repeated-measure analysis of variance. ResultsDepending on stent type, scanner hardware, and convolution kernel, artificial lumen narrowing ranged from 20% to 100%. The convolution kernel had the most significant influence on the visibility of the stent lumen. Artificial lumen narrowing and intraluminal attenuation changes decreased significantly using the dedicated convolution kernel. In general, most severe artifacts were caused by gold or gold-coated stents. ConclusionsIndependent of the scanner hardware or dedicated convolution kernels, routine evaluation of most coronary artery stents is not yet feasible using MSCT.

[1]  M. Völk,et al.  Appearance of Vascular Stents in Computed Tomographic Angiography: In Vitro Examination of 14 Different Stent Types , 2001, Investigative radiology.

[2]  E. Wenkel,et al.  Noninvasive visualization of coronary arteries using contrast-enhanced multidetector CT: influence of heart rate on image quality and stenosis detection. , 2002, AJR. American journal of roentgenology.

[3]  R Erbel,et al.  Coronary arterial stent patency: assessment with electron-beam CT. , 2000, Radiology.

[4]  L. Bonomo,et al.  Images in cardiovascular medicine. Multislice spiral computed tomography for in-stent restenosis. , 2002, Circulation.

[5]  J Simon,et al.  New Technical Developments in Multislice CT, Part 2: Sub-Millimeter 16-Slice Scanning and Increased Gantry Rotation Speed for Cardiac Imaging , 2002, RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin.

[6]  Matthijs Oudkerk,et al.  Coronary angiography with multi-slice computed tomography , 2001, The Lancet.

[7]  René M. Botnar,et al.  Coronary magnetic resonance angiography for assessment of the stent lumen: a phantom study. , 2002, Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance.

[8]  Walter Heindel,et al.  Imaging of coronary artery stents using multislice computed tomography: in vitro evaluation , 2003, European Radiology.

[9]  W. Bautz,et al.  Detection of Coronary Artery Stenoses With Thin-Slice Multi-Detector Row Spiral Computed Tomography and Multiplanar Reconstruction , 2003, Circulation.

[10]  A. Mahnken,et al.  Multislice spiral computed tomography for the detection of coronary stent restenosis and patency. , 2003, International journal of cardiology.

[11]  Rainer Raupach,et al.  Spatial domain image filtering in computed tomography: feasibility study in pulmonary embolism , 2003, European Radiology.

[12]  H. Bienert,et al.  Development of a New Biodegradable Intravascular Polymer Stent with Simultaneous Incorporation of Bioactive Substances , 1999, The International journal of artificial organs.

[13]  H. Oswald,et al.  Coronary arterial stents: safety and artifacts during MR imaging. , 2000, Radiology.

[14]  R. Günther,et al.  Artifact-Free In-Stent Lumen Visualization by Standard Magnetic Resonance Angiography Using a New Metallic Magnetic Resonance Imaging Stent , 2002, Circulation.

[15]  P. Serruys,et al.  Angiographic Findings of the Multicenter Randomized Study With the Sirolimus-Eluting Bx Velocity Balloon-Expandable Stent (RAVEL): Sirolimus-Eluting Stents Inhibit Restenosis Irrespective of the Vessel Size , 2002, Circulation.

[16]  V. Boddi,et al.  Restenosis after coronary stenting in current clinical practice. , 1998, American heart journal.

[17]  Mary E. Russell,et al.  TAXUS I: Six- and Twelve-Month Results From a Randomized, Double-Blind Trial on a Slow-Release Paclitaxel-Eluting Stent for De Novo Coronary Lesions , 2003, Circulation.

[18]  D Maintz,et al.  Multislice CT angiography of the iliac arteries in the presence of various stents: in vitro evaluation of artifacts and lumen visibility. , 2001, Investigative radiology.

[19]  E. Topol.  Coronary-artery stents--gauging, gorging, and gouging. , 1998, The New England journal of medicine.

[20]  M. Reiser,et al.  Cardiac imaging by means of electrocardiographically gated multisection spiral CT: initial experience. , 2000, Radiology.

[21]  D. Grönemeyer,et al.  Minimally invasive evaluation of coronary stents with electron beam computed tomography: In vivo and in vitro experience , 1999, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[22]  I. Komuro,et al.  Coronary Artery Patency After Metallic Stent Implantation Evaluated by Multislice Computed Tomography , 2003 .