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Optimized intravenous Flat Detector CT for non-invasive visualization of intracranial stents: first results

Optimized intravenous Flat Detector CT for non-invasive visualization of intracranial stents: first results,10.1007/s00330-010-1931-3,European Radiolo

Optimized intravenous Flat Detector CT for non-invasive visualization of intracranial stents: first results   (Citations: 4)
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Objective  As stents for treating intracranial atherosclerotic stenosis may develop in-stent re-stenosis (ISR) in up to 30%, follow-up imaging is mandatory. Residual stenosis (RS) is not rare. We evaluated an optimised Flat Detector CT protocol with intravenous contrast material application (i.v. FD-CTA) for non-invasive follow-up. Methods  In 12 patients with intracranial stents, follow-up imaging was performed using i.v. FD-CTA. MPR, subtracted MIP and VRT reconstructions were used to correlate to intra-arterial angiography (DSA). Two neuroradiologists evaluated the images in anonymous consensus reading and calculated the ISR or RS. Correlation coefficients and a Wilcoxon test were used for statistical analysis. Results  In 4 patients, no stenosis was detected. In 6 patients RS and in two cases ISR by intima hyperplasia perfectly visible on MPR reconstructions of i.v. FD-CTA were detected. Wilcoxon’s test showed no significant differences between the methods (p > 0.05). We found a high correlation with coefficients of the pairs DSA/ FD-CT MIP r = 0.91, DSA/ FD-CT MPR r = 0.82 and FD-CT MIP/ FD-CT MPR r = 0.8. Conclusion  Intravenous FD-CTA could clearly visualise the stent and the lumen, allowing ISR or RS to be recognised. FD-CTA provides a non-invasive depiction of intracranial stents and might replace DSA for non-invasive follow-up imaging.
Journal: European Radiology - EUROPEAN RADIOL , vol. 21, no. 2, pp. 411-418, 2011
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    • ...Struffert et al. described an optimised FD-CT program and published a small series of patients [25]...

    Tobias Struffertet al. Flat-detector computed tomography in the assessment of intracranial st...

    • ...Recently, a new method of visualising the lumen of intracranial stents used for treatment of intracranial atherosclerotic disease by Flat-Detector CT Angiography (FD-CTA) has been introduced [6]...
    • ...Here we used a 10s_DSA program as described before [6, 7]. Postprocessing of the 3-D DSA and the FD-CTAwas performed using commercially available software (syngo XWP, DynaCT, InSpace 3D software, Siemens AG, Healthcare Sector, Forchheim, Germany)...
    • ...We performed the identical reconstruction of the intravenous FD-CTA as described before [6, 7]. Here a Dual volume reconstruction is also possible and, additionally due to the adequate soft tissue resolutionthat is not possible in the 5s_DSA program, multiplanar reconstructions with and without contrast material to analyse the lumen of the device and the aneurysm were performed...
    • ...A detailed description of the post-processing with all parameters has been published [6, 7]. We used 60 mL of contrast material (Imeron 400, Bracco Imaging, Konstanz, Germany) injected into a peripheral cubital vein at a rate of 5 mL/s using a power injector(MEDTRON,Saarbruecken,Germany)followedbya saline chaser (60 ml, injection rate 5 ml/s...
    • ...The appearance of these artefacts is similar to those of the markers of the Wingspan stent (Wingspan; Boston Scientific/Target, Fremont, CA, USA), which have been described before [6]...
    • ...Experience in regular stent devices indicates, that in patients with good compliance a sufficient image quality can be achieved without general aesthesia [6]...

    Tobias Struffertet al. Intravenous flat detector CT angiography for non-invasive visualisatio...

    • ...setup. The use of IV FDCT has been previously described in the literature on few patients [13], and its benefits were clearly emphasized [13, 20, 21]...

    Raphaël Blancet al. Intravenous flat-detector CT angiography in acute ischemic stroke mana...

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