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64-slice multidetector coronary CT angiography: in vitro evaluation of 68 different stents

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Abstract

The purpose of this study was to test a large sample of different coronary artery stents using four image reconstruction approaches with respect to lumen visualization, lumen attenuation, and image noise in 64-slice multidetector-row computed tomography (MDCT) in vitro and to provide a catalogue of currently used coronary artery stents when imaged with state-of the-art MDCT. We examined 68 different coronary artery stents (57 stainless steel, four cobalt-chromium, one cobalt-alloy, two nitinol, four tantalum) in a coronary artery phantom (vessel diameter 3 mm, intravascular attenuation 250 HU, extravascular density −70). Stents were imaged in axial orientation with standard parameters: 32x0.6 collimation, pitch 0.24, 680 mAs, 120 kV, rotation time 0.37 s. Four different image reconstructions were obtained with varying convolution kernels and section thicknesses: (1) soft, 0.6 mm, (2) soft, 0.75, (3) medium soft, 0.6, and (4) stent-optimized sharp, 0.6. To evaluate visualization characteristics of of the stent, the lumen diameter, intraluminal density and noise were measured. The high-resolution kernel offered significantly better average lumen visualization (57% ±10%) and more realistic lumen attenuation (222 HU ±66 HU) at the expense of increased noise (15.3 HU ±3.7 HU) compared with the soft and medium-soft CT angiography (CTA) protocol (p<0.001 for all). Stents with a lumen visibility of more than 66% were: Arthos pico, Driver, Flex, Nexus2, S7, Tenax complete, Vision (all 67%), Symbiot, Teneo (70%), and Radius (73%). Only ten stents showed a lumen visibility of less than 50%. Stent lumen visibility largely varies depending on the stent type. Even with the improved spatial resolution of 64-slice CT, a stent-optimized kernel remains beneficial for stent visualization when compared with the standard medium-soft CTA protocol. Using 64-slice CT and high-resolution kernel, the majority of stent products show a lumen visibility of more than 50% of the stent diameter.

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Acknowledgements

The authors would like to thank all companies that provided stents for the in vitro evaluations and information about their products.

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Authors and Affiliations

  1. Department of Clinical Radiology, University of Muenster, Albert-Schweitzer-Str. 33, 48129, Münster, Germany

    David Maintz, Harald Seifarth, Michael Rink, Murat Özgün, Walter Heindel & Roman Fischbach

  2. Siemens Medical Solutions, Forchheim, Germany

    Rainer Raupach & Thomas Flohr

  3. Department of Radiology, University of Bonn, Bonn, Germany

    Torsten Sommer

Authors
  1. David Maintz
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  2. Harald Seifarth
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  3. Rainer Raupach
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  4. Thomas Flohr
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  5. Michael Rink
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  6. Torsten Sommer
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  7. Murat Özgün
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  8. Walter Heindel
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  9. Roman Fischbach
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Correspondence to David Maintz.

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Maintz, D., Seifarth, H., Raupach, R. et al. 64-slice multidetector coronary CT angiography: in vitro evaluation of 68 different stents. Eur Radiol 16, 818–826 (2006). https://doi.org/10.1007/s00330-005-0062-8

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  • DOI: https://doi.org/10.1007/s00330-005-0062-8

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