Evaluation of stent visibility by flat panel detector CT in patients treated for intracranial aneurysms.
BACKGROUND
This study aimed to evaluate the visibility of stents using high-resolution computed tomography (CT) acquisitions acquired with flat panel detector (XperCT, Allura series, Philips Healthcare, The Netherlands) for endovascular treatment of intracranial aneurysms.


METHODS
On a 24-month period, 48 patients endovascularly treated by coiling and stenting (59 stents) for intracranial aneurysms were explored by flat panel detector CT technique. A sequence of 620 2D images was acquired over an angle of 240° using a 1,024 × 1,024 pixel matrix detector within a 48-cm field of view. The images were retrospectively analyzed independently by two neuroradiologists. Evaluation criteria were percentage of visualization of the stents and stent deployment (kinking or unsatisfactory deployment of the stent).


RESULTS
Evaluation of the stent was feasible for all the patients. Stent visibility by XperCT was overall estimated at 76% of the stent length. Difficulties to analyze the stents were related to coil artifacts but not to packing density or aneurysm location. Stent length visualization was higher when the acquisition was performed before additional coiling (P < 0.0001). Mild kinking/misdeployment was noticed in 22% of the cases.


CONCLUSIONS
XperCT technique provides multiplanar and 3D reconstructions that allows for a satisfying visualization of intracranial stents. This CT-like acquisition should be performed after the stent deployment and before coiling, in order to obtain better stent visualization.
Groupe Hospitalier Pitié-Salpêtrière, 47 Bd de l'Hôpital, 75013 Paris, France. fredclare5@msn.com
Frédéric
F
Clarençon
Michel
M
Piotin
Silvia
S
Pistocchi
Drazenko
D
Babic
Raphaël
R
Blanc
D000328:Adult; D000368:Aged; D001807:Blood Vessel Prosthesis; D002533:Cerebral Angiography / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015607:Stents; D014057:Tomography, X-Ray Computed / Q000295:instrumentation*; D016896:Treatment Outcome; D014963:X-Ray Intensifying Screens