Diagnostic value of CT virtual intravascular endoscopy in aortic stent-grafting.
OBJECTIVE
To investigate the diagnostic value of postprocessing techniques for 3-dimensional (3D) computed tomography (CT), with emphasis on CT virtual intravascular endoscopy (VIE), in patients with abdominal aortic aneurysms (AAA) treated with suprarenal stent-grafts.


METHODS
The preprocedural and postprocedural CT datasets from 47 AAA patients (40 men; mean age 75 years, range 61-87) undergoing aortic stent-grafting with suprarenal fixation were examined. The CT datasets were processed to create various 3D reconstructions: shaded surface display (SSD), maximum intensity projection (MIP), and VIE. Three independent radiologists assessed various diagnostic parameters for each 3D reconstruction method and compared them to axial CT images.


RESULTS
Scores for VIE reconstructions were inferior to axial CT images in the visualization of normal arterial branches, measurement of the aneurysm diameter and neck length, as well as assessment of vessel patency and presence of endoleaks. VIE was rated superior to axial CT and other 3D imaging methods in visualizing the configuration of stent struts relative to the aortic branch ostia and the number of stent wires crossing the ostia in >80% of cases.


CONCLUSIONS
VIE was not found to play a role in most preoperative situations compared to axial CT images. However, VIE provided additional postgrafting information on the 3D relationship of the suprarenal stent struts to the aortic branch ostia (in particular the renal and superior mesenteric arteries). VIE findings might aid clinicians in accurately assessing the effect of suprarenal stent-grafting on the renal arteries.
Sun
Zhonghua
Z
School of Applied Medical Sciences and Sports Studies, University of Ulster, Newtownabbey, Northern Ireland, UK. ZH.Sun@ulster.ac.uk
Winder
R John
RJ
Kelly
Barry E
BE
Ellis
Peter K
PK
Kennedy
Peter T
PT
Hirst
David G
DG
D000368:Aged; D000369:Aged, 80 and over; D017546:Angioscopy / Q000379:methods*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D015607:Stents; D036542:Tomography, Spiral Computed