title: Evaluation of middle cerebral artery stents using multidetector row CT angiography in vivo study: comparison of the three different kernels.
abstract: BACKGROUND
  There are very few reports assessing middle cerebral artery (MCA) stents using multidetector computed tomography (MDCT).
  
  
  OBJECTIVE
  To assess MCA stents using multidetector CT angiography (CTA) in vivo evaluation: the differences in the CTA results according to the three different kernels.
  
  
  METHODS
  We retrospectively evaluated 27 MCA stents from 26 patients who underwent CTA with 16- and 64-slice MDCT after percutaneous transluminal angioplasty and stenting (PTAS). By CTA, using medium-smooth kernel (B30), medium-sharp kernel (B50), and sharp kernel (B60), the lumen diameter, artificial luminal narrowing (ALN), and subjective visibility score of the stented vessels were evaluated. The subjective visibility score ranged from 1 (poor quality) to 5 (excellent) using a five-point scale.
  
  
  RESULTS
  There were excellent inter-observer agreements for the lumen diameter measurements (P < 0.001). The mean diameter of the stented vessels was 2.10 ± 0.31 mm on digital subtraction angiography (DSA), 0.93 ± 0.20 mm on CTA using B30, 1.18 ± 0.27 mm on CTA using B50, and 1.29 ± 0.29 mm on CTA using B60. The mean ALN was 55.7 ± 6.0% on CTA using B30, 43.8 ± 7.5% on CTA using B50, and 38.7 ± 8.3% on CTA using B60. CTA with higher kernels had a smaller ALN than images with smaller kernels. The median subjective visibility score on the CTA using B50 was 3, which was higher than for the other kernels. The differences in the lumen diameter, ALN, and the subjective visibility score of the stented vessels on CTA using the three different kernels was statistically significant (P < 0.001).
  
  
  CONCLUSIONS
  The sharp kernel was better to assess the lumen diameter and ALN, but was inferior to the medium-sharp kernel for in-stent evaluation due to high image-to-noise. CTA with medium-sharp kernel showed good lumen visibility and acceptable ALN for MCA stents. This could therefore be a non-invasive, readily applicable clinical method for assessing MCA stent patency after stent placement.
authors.affiliation: Department of Radiology, Bucheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea.
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Jang
authors.forename: Yeon Soo
authors.initials: YS
authors.lastname: Lim
authors.forename: Youn Joo
authors.initials: YJ
authors.lastname: Lee
authors.forename: Won Jong
authors.initials: WJ
authors.lastname: Yoo
authors.forename: Mi Sook
authors.initials: MS
authors.lastname: Sung
authors.forename: Bum Soo
authors.initials: BS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D017130:Angioplasty; D002533:Cerebral Angiography / Q000379:methods*; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging* / Q000628:therapy*; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging*; D011856:Radiographic Image Enhancement / Q000379:methods*; D012189:Retrospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed / Q000379:methods*