Wiesinger Benjamin, Stütz Alexander, Schmehl Jörg, Groezinger Gerd, Claussen Claus Detlef, Wiskirchen Jakub
Division of Diagnostic Radiology, Department of Radiology, University of Tübingen, Bielefeld, Germany.
Acta Radiol. 2012 Nov 1;53(9):1020-5. doi: 10.1258/ar.2012.120187. Epub 2012 Sep 11.
Sufficient radiopacity of stents is a prerequisite for safe interventions and minimization of the radiation dose for the patient and the interventionist. Modern nitinol stents are considered less radiopaque compared to formerly used stents.
To evaluate the objective detection rate (ODR) and the subjective radiopacity score (SRS) of four self-expanding nitinol stents with their markers on a phantom human pelvis.
We evaluated the ODR (as a percentage of correctly identified stents) and the SRS (on a scale from 0 = not visible to 4 = excellent visibility) for four self-expanding nitinol stents (SinusSuperflex, SMART, Luminexx, Zilver) with 8 mm diameter and 40 mm length. Stents were placed on a phantom human pelvis and images of the stents were taken in four different positions (right and left lumbosacral joint and near the right and left limbus acetabuli) using the following modes: spotfilm, pulsed fluoroscopy (4, 7.5, 15, and 30 pulses/min) and at three different digital magnification modes. Dose area products (DAPs) were assessed.
ODR and SRS, respectively, were significantly increased for the SMART stent compared to all other tested stents (P < 0.05): SMART 93.53% and 2.43, SinusSuperflex 90.81% and 2.21, Luminexx 90.39% and 2.20, and Zilver 89.28% and 2.21. ODR was significantly reduced in position 3 where the bone overlap was more pronounced for all stents (detection rates 77.14-79.56%). An increase in magnification significantly improved the ODR and SRS for all stents (70.33-99.25% and 1.07-3.28, respectively, P < 0.05). Increased pulsing frequency did not improve the ODR of the various stents but did increase the DAP.
The SMART stent had the best overall performance. In the presence of bone overlap, all self-expanding nitinol stents had poor results. Increased pulsing frequency did not improve ODR or SRS but did increase the DAP. Use of digital magnification modes had no effect on DAP increasing ODR and SRS.
支架具有足够的射线不透性是安全干预以及将患者和介入医生所受辐射剂量降至最低的前提条件。与以前使用的支架相比，现代镍钛诺支架的射线不透性被认为较低。
评估四种带有标记物的自膨胀镍钛诺支架在人体骨盆模型上的客观检测率（ODR）和主观射线不透性评分（SRS）。
我们评估了四种直径8毫米、长度40毫米的自膨胀镍钛诺支架（SinusSuperflex、SMART、Luminexx、Zilver）的ODR（正确识别支架的百分比）和SRS（评分范围从0 = 不可见至4 = 可视性极佳）。将支架放置在人体骨盆模型上，并使用以下模式在四个不同位置（左右腰骶关节以及左右髋臼缘附近）拍摄支架图像：点片、脉冲透视（4、7.5、15和30脉冲/分钟）以及三种不同的数字放大模式。评估剂量面积乘积（DAP）。
与所有其他测试支架相比，SMART支架的ODR和SRS分别显著提高（P < 0.05）：SMART支架的ODR为93.53%，SRS为2.43；SinusSuperflex支架的ODR为90.81%，SRS为2.21；Luminexx支架的ODR为90.39%，SRS为2.20；Zilver支架的ODR为89.28%，SRS为2.21。在位置3，所有支架的骨骼重叠更为明显，ODR显著降低（检测率77.14 - 79.56%）。放大倍数增加显著提高了所有支架的ODR和SRS（分别为70.33 - 99.25%和1.07 - 3.28，P < 0.05）。脉冲频率增加并未改善各种支架的ODR，但确实增加了DAP。
SMART支架总体性能最佳。在存在骨骼重叠的情况下，所有自膨胀镍钛诺支架的效果都较差。脉冲频率增加并未改善ODR或SRS，但增加了DAP。使用数字放大模式对增加ODR和SRS的DAP没有影响。
