Lee Youn Joo, Lim Yeon Soo, Jung Na Young, Yoo Won Jong, Sung Mi Sook, Chung Myung Hee, Kim Bum Soo
Department of Radiology, Bucheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Republic of Korea.
J Comput Assist Tomogr. 2013 May-Jun;37(3):402-7. doi: 10.1097/RCT.0b013e318289a9f9.
The objective of this study was to assess the lumen visibility of carotid artery stents using multi-detector-row computed tomography (MDCT) angiography; compare medium-smooth, medium-sharp, and sharp kernels; and correlate these results to those of digital subtraction angiography (DSA).
We retrospectively evaluated 52 stents from 51 patients who underwent 16- and 64-slice MDCT angiography. Lumen diameters were measured 3 times by 2 neuroradiologists, and artificial luminal narrowing was calculated. To assess detection of in-stent restenosis (>50%), 2 neuroradiologists evaluated all MDCT and DSA images.
Excellent intraobserver and interobserver agreements were obtained for the lumen diameter measurements (P < 0.001). Lumen diameter visibility improved, and artificial luminal narrowing decreased from the medium-smooth kernel to the sharp kernel. Visual estimation of all CT angiography using the 3 kernels showed high accuracy for detection of in-stent restenosis (>50%), compared with DSA.
Computed tomography angiography using a sharp kernel allows for more accurate assessment of lumen visibility after carotid artery stenting.
本研究的目的是使用多排螺旋计算机断层扫描(MDCT)血管造影评估颈动脉支架的管腔可视性;比较中等平滑、中等锐利和锐利内核;并将这些结果与数字减影血管造影(DSA)的结果相关联。
我们回顾性评估了51例接受16层和64层MDCT血管造影的患者的52个支架。由2名神经放射科医生对管腔直径进行3次测量,并计算人为管腔狭窄。为了评估支架内再狭窄(>50%)的检测情况,2名神经放射科医生对所有MDCT和DSA图像进行了评估。
管腔直径测量获得了极好的观察者内和观察者间一致性(P < 0.001)。从中等平滑内核到锐利内核,管腔直径可视性提高,人为管腔狭窄降低。与DSA相比,使用这3种内核的所有CT血管造影的视觉估计对支架内再狭窄(>50%)的检测具有较高的准确性。
使用锐利内核的计算机断层扫描血管造影能够更准确地评估颈动脉支架置入术后的管腔可视性。