Evaluation of various image reconstruction parameters in lower extremity stents using multidetector-row CT angiography: initial findings.
Image quality, visible lumen and patency of lower limb stents was assessed by multidetector-row computed tomography (MDCT) angiography using various reconstruction parameters and the results compared with conventional angiography. Fourteen patients (25 stents) were evaluated. From MDCT datasets, axial and coronal oblique reformations were reconstructed using differing reconstruction parameters (slice thickness, kernel, views). Artifacts and image quality were assessed using a five-degree scale (1=excellent, 5=poor). Visible stent diameter was measured. Stenosis severity was compared with calibrated catheter angiography. The image quality of medium and sharp image kernels were good/fair (1.9-2.4), while smooth kernel provided only acceptable/poor image quality (3.9-4.4). Coronal oblique images were rated superior to assess in-stent lumen rather than axial. Using medium and sharp kernels, the visible stent lumen was significantly greater than using smooth kernel (P<0.001). thirteen out of fourteen patients (24/25 stents) were correctly classified as patent. In one patient, in-stent stenosis (> or =50%) was falsely diagnosed using CT angiography (CTA) with smooth kernel and was, therefore, rated as false positive. Coronal oblique views, as well as medium and sharp kernels, have shown the best results regarding image quality to assess stent patency in the lower limb. Therefore, MDCT could be a valuable non-invasive modality for stent imaging in the peripheral vasculature.
Heuschmid
Martin
M
Department of Diagnostic Radiology, University Hospital Tuebingen, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076 Tuebingen, Germany. martin.heuschmid@med.uni-tuebingen.de
Wiesinger
Benjamin
B
Tepe
Gunnar
G
Luz
Oliver
O
Kopp
Andreas F
AF
Claussen
Claus D
CD
Duda
Stephan H
SH
D000368:Aged; D000792:Angiography / Q000379:methods*; D015901:Angiography, Digital Subtraction; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D016477:Artifacts; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D015607:Stents; D014057:Tomography, X-Ray Computed / Q000379:methods