Poncyljusz Wojciech, Zwarzany Łukasz, Safranow Krzysztof
Departament of Interventional Radiology, Pomeranian Medical University, Neurointerventional Cath Lab MSW Hospital, Al. Powst. Wielkopolskich 72, 70-111 Szczecin, Poland.
Department of Biochemistry and Chemistry, Pomeranian Medical University, Al. Powst. Wielkopolskich 72, 70-111 Szczecin, Poland.
Eur J Radiol. 2015 Jul;84(7):1313-7. doi: 10.1016/j.ejrad.2015.04.015. Epub 2015 Apr 27.
The aim of our study was to evaluate the feasibility of contrast-enhanced flat panel detector CT (FPDCT) for visualizing the novel microstents implanted in patients with unruptured wide-necked intracranial aneurysms.
Forty-four cases of patients who underwent stent assisted coiling at our department were retrospectively analyzed. In each case, FPDCT images were performed after stent and coils deployment and then assessed in the terms of stent struts and all radiopaque markers and tantalum strands visibility separately using a 3-grade scale (1 - inadequate, 2 - good, 3 - excellent).
Stent struts visibility was assessed to be inadequate for evaluation in all cases. All radiopaque markers and tantalum strands visibility was excellent in 61.4% and good in 38.6% of cases. We observed 4 (9.09%) cases of incomplete stent opening. Treated aneurysm size <10mm was an independent predictor of excellent stent all radiopaque markers and tantalum strands visibility (ρ=0.014).
Contrast-enhanced FPDCT is feasible for visualizing stents implanted in patients with intracranial aneurysms as it gives precise visualization of the relationships between the stent tantalum strands and the vessel wall. Stents used in the treatment of aneurysms ≥10 mm in size are worse visualized because of the coil streaking artifacts.
本研究旨在评估对比增强平板探测器CT（FPDCT）用于可视化未破裂宽颈颅内动脉瘤患者植入的新型微支架的可行性。
回顾性分析在我科接受支架辅助弹簧圈栓塞治疗的44例患者。每例患者在支架和弹簧圈置入后均行FPDCT成像，然后分别使用3级评分标准（1 - 差，2 - 良好，3 - 优秀）对支架支柱、所有不透射线标记物和钽丝的可视性进行评估。
所有病例中支架支柱的可视性均差，无法进行评估。61.4%的病例中所有不透射线标记物和钽丝的可视性为优秀，38.6%为良好。我们观察到4例（9.09%）支架未完全打开。治疗的动脉瘤大小<10mm是支架所有不透射线标记物和钽丝可视性优秀的独立预测因素（ρ=0.014）。
对比增强FPDCT可用于可视化颅内动脉瘤患者植入的支架，因为它能精确显示支架钽丝与血管壁之间的关系。由于弹簧圈伪影，用于治疗大小≥10mm动脉瘤的支架可视性较差。
