Hayashi Takuma, Fukuda Atsushi
Department of Radiology, Shiga General Hospital.
Virginia Commonwealth University Medical Center (Current address: Preparing Section for New Faculty of Medical Science, Fukushima Medical University).
Nihon Hoshasen Gijutsu Gakkai Zasshi. 2019;75(8):747-754. doi: 10.6009/jjrt.2019_JSRT_75.8.747.
In recent years, various types of stents are deployed for the treatment of intracranial artery stenosis and aneurysms. Digital subtraction angiography has been considered to be the gold standard for the follow-up study. However, magnetic resonance angiography (MRA) is less invasive and the recent advances may contribute to the imaging of patients with intracranial stents. Then, a phantom study was carried out to evaluate the MR lumen visibility with these stents. Four stents [low-profile visualized intraluminal support (LVIS), Neuroform Atlas, Neuroform EZ, and Enterprise 2] were placed into plastic tubes with 3 mm inner diameter, and fixed in a container filled with agar. Time-of-flight MRA (TOF-MRA) was performed for these stents, and the signal intensities inside and outside the stents were measured on ImageJ software. Furthermore, 25%, 50%, and 75% stenosis models were created and passed through these stents to evaluate the diagnostic accuracy of in-stent stenosis. The signal intensity inside the LVIS stent was the highest among the four stents (P<0.001), and no significant difference was found between the signal intensities inside and outside the LVIS stent. The diagnostic accuracy with LVIS was also higher than that of Enterprise 2 (P<0.001). In conclusion, the visibility with LVIS indicates that TOF-MRA could be reliably utilized as a diagnostic tool for the detection of in-stent stenosis.
近年来，各种类型的支架被用于治疗颅内动脉狭窄和动脉瘤。数字减影血管造影一直被认为是随访研究的金标准。然而，磁共振血管造影（MRA）侵入性较小，且最近的进展可能有助于颅内支架植入患者的成像。然后，进行了一项体模研究以评估这些支架的磁共振管腔可视性。将四个支架[低轮廓可视腔内支撑（LVIS）、Neuroform Atlas、Neuroform EZ和Enterprise 2]放入内径为3毫米的塑料管中，并固定在装满琼脂的容器中。对这些支架进行了时间飞跃MRA（TOF-MRA），并在ImageJ软件上测量了支架内外的信号强度。此外，创建了25%、50%和75%的狭窄模型并通过这些支架，以评估支架内狭窄的诊断准确性。LVIS支架内的信号强度在四个支架中最高（P<0.001），LVIS支架内外的信号强度之间未发现显著差异。LVIS的诊断准确性也高于Enterprise 2（P<0.001）。总之，LVIS的可视性表明TOF-MRA可以可靠地用作检测支架内狭窄的诊断工具。
