title: Coronary artery stent geometry and in-stent contrast attenuation with 64-slice computed tomography.
abstract: We aimed at assessing stent geometry and in-stent contrast attenuation with 64-slice CT in patients with various coronary stents. Twenty-nine patients (mean age 60 +/- 11 years; 24 men) with 50 stents underwent CT within 2 weeks after stent placement. Mean in-stent luminal diameter and reference vessel diameter proximal and distal to the stent were assessed with CT, and compared to quantitative coronary angiography (QCA). Stent length was also compared to the manufacturer's values. Images were reconstructed using a medium-smooth (B30f) and sharp (B46f) kernel. All 50 stents could be visualized with CT. Mean in-stent luminal diameter was systematically underestimated with CT compared to QCA (1.60 +/- 0.39 mm versus 2.49 +/- 0.45 mm; P < 0.0001), resulting in a modest correlation of QCA versus CT (r = 0.49; P < 0.0001). Stent length as given by the manufacturer was 18.2 +/- 6.2 mm, correlating well with CT (18.5 +/- 5.7 mm; r = 0.95; P < 0.0001) and QCA (17.4 +/- 5.6 mm; r = 0.87; P < 0.0001). Proximal and distal reference vessel diameters were similar with CT and QCA (P = 0.06 and P = 0.03). B46f kernel images showed higher image noise (P < 0.05) and lower in-stent CT attenuation values (P < 0.001) than images reconstructed with the B30f kernel. 64-slice CT allows measurement of coronary artery in-stent density, and significantly underestimates the true in-stent diameter compared to QCA.
authors.affiliation: Cardiovascular Center, University Hospital Zurich, Raemistr. 100, CH-8091 Zurich, Switzerland.
authors.forename: Tiziano
authors.initials: T
authors.lastname: Schepis
authors.forename: Pascal
authors.initials: P
authors.lastname: Koepfli
authors.forename: Sebastian
authors.initials: S
authors.lastname: Leschka
authors.forename: Lotus
authors.initials: L
authors.lastname: Desbiolles
authors.forename: Lars
authors.initials: L
authors.lastname: Husmann
authors.forename: Oliver
authors.initials: O
authors.lastname: Gaemperli
authors.forename: Franz R
authors.initials: FR
authors.lastname: Eberli
authors.forename: Simon
authors.initials: S
authors.lastname: Wildermuth
authors.forename: Borut
authors.initials: B
authors.lastname: Marincek
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Lüscher
authors.forename: Hatem
authors.initials: H
authors.lastname: Alkadhi
authors.forename: Philipp A
authors.initials: PA
authors.lastname: Kaufmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016477:Artifacts; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011857:Radiographic Image Interpretation, Computer-Assisted; D015607:Stents; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome