Groupe Hospitalier Pitié-Salpêtrière, 47 Bd de l'Hôpital, 75013 Paris, France.
Neuroradiology. 2012 Oct;54(10):1121-5. doi: 10.1007/s00234-011-1002-8. Epub 2012 Feb 4.
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.
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).
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.
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.
本研究旨在评估使用平板探测器（XperCT，Allura 系列，荷兰皇家飞利浦公司）进行的高分辨率计算机断层扫描（CT）采集在颅内动脉瘤血管内治疗中对支架的可视性。
在 24 个月的时间内，对 48 例采用血管内弹簧圈和支架（59 个支架）治疗颅内动脉瘤的患者进行了平板探测器 CT 技术检查。使用 1024×1024 像素矩阵探测器在 48 厘米视野内采集 240°角度的 620 个 2D 图像。由两位神经放射科医生独立对图像进行回顾性分析。评估标准为支架的可视化百分比和支架放置情况（支架扭结或放置不满意）。
所有患者的支架评估均可行。XperCT 对支架的可视性总体估计为支架长度的 76%。分析支架困难与线圈伪影有关，但与线圈密度或动脉瘤位置无关。在进行额外的线圈缠绕之前进行采集时，支架长度的可视化程度更高（P<0.0001）。在 22%的病例中发现轻度扭结/放置不当。
XperCT 技术提供了多平面和 3D 重建，可实现对颅内支架的满意可视化。这种类似 CT 的采集应在支架放置后和线圈缠绕之前进行，以获得更好的支架可视化效果。
