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Update on multidetector coronary CT angiography of coronary stents: in vitro evaluation of 29 different stent types with dual-source CT

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Abstract

The aim of this study was to test a large sample of the latest coronary artery stents using four image reconstruction approaches with respect to lumen visualization, lumen attenuation, and image noise in dual-source multidetector row CT (DSCT) in vitro and to provide a CT catalogue of currently used coronary artery stents. Twenty-nine different coronary artery stents (19 steel, 6 cobalt-chromium, 2 tantalum, 1 iron, 1 magnesium) were examined in a coronary artery phantom (vessel diameter 3 mm, intravascular attenuation 250 HU, extravascular density −70 HU). Stents were imaged in axial orientation with standard parameters: 32 × 0.6 collimation, pitch 0.24, 400 mAs, 120 kV, rotation time 0.33 s. Image reconstructions were obtained with four different convolution kernels (soft, medium-soft, standard high-resolution, stent-dedicated). To evaluate visualization characteristics of the stent, the lumen diameter, intraluminal density, and noise were measured. The stent-dedicated kernel offered best average lumen visualization (54 ± 8.3%) and most realistic lumen attenuation (222  ± 44 HU) at the expense of increased noise (23.9 ± 1.9 HU) compared with standard CTA protocols (p < 0.001 for all). The magnesium stent showed the least artifacts with a lumen visibility of 90%. The majority of stents (79%) exhibited a lumen visibility of 50–59%. Less than half of the stent lumen was visible in only six stents. Stent lumen visibility largely varies depending on the stent type. Magnesium is by far more favorable a stent material with regard to CT imaging when compared with the more common materials steel, cobalt-chromium, or tantalum. The magnesium stent exhibits a lumen visibility of 90%, whereas the majority of the other stents exhibit a lumen visibility of 50–59%.

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Acknowledgements

The authors would like to thank all companies for providing their stents for in vitro evaluation and for the required information on their products.

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Authors and Affiliations

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

    David Maintz, Matthias C. Burg, Harald Seifarth, Alexander C. Bunck, Murat Özgün, Roman Fischbach, Kai Uwe Jürgens & Walter Heindel

  2. Department of Radiology and Nuclear Medicine, Asklepios Klinikum Altona, Hamburg, Germany

    Roman Fischbach

Authors
  1. David Maintz
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  2. Matthias C. Burg
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  3. Harald Seifarth
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  4. Alexander C. Bunck
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  5. Murat Özgün
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  6. Roman Fischbach
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  7. Kai Uwe Jürgens
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  8. Walter Heindel
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Corresponding author

Correspondence to David Maintz.

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David Maintz and Matthias Burg contributed equally to this publication.

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Maintz, D., Burg, M.C., Seifarth, H. et al. Update on multidetector coronary CT angiography of coronary stents: in vitro evaluation of 29 different stent types with dual-source CT. Eur Radiol 19, 42–49 (2009). https://doi.org/10.1007/s00330-008-1132-5

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  • DOI: https://doi.org/10.1007/s00330-008-1132-5

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