Coronary artery stents in multislice computed tomography: in vitro artifact evaluation

Area of Science:

• Cardiovascular Imaging
• Medical Imaging Technology
• CT Scan Analysis

Background:

• Coronary artery stents are crucial for treating stenotic lesions.
• Accurate assessment of stented coronary arteries is vital for patient management.
• Multislice spiral CT (MSCT) is a common imaging modality, but its efficacy with coronary stents is debated.

Purpose of the Study:

• To systematically compare the capability of MSCT to evaluate coronary artery lumen patency in the presence of various coronary artery stents.
• To investigate the impact of different MSCT scanner hardware and convolution kernels on image quality and artifact generation.

Main Methods:

• Ten distinct coronary artery stent types were evaluated using both 4- and 16-detector row MSCT scanners.
• Image reconstruction was performed using a standard kernel and a dedicated kernel optimized for coronary stent visualization.
• Analysis focused on lumen visibility, intraluminal attenuation, and extra-stent artifacts, with results statistically compared.

Main Results:

• Artificial lumen narrowing varied widely (20%-100%) depending on stent type, scanner, and kernel.
• The convolution kernel exerted the most significant influence on stent lumen visibility.
• Use of a dedicated convolution kernel substantially reduced artificial lumen narrowing and intraluminal attenuation changes.
• Gold or gold-coated stents generally produced the most severe artifacts.

Conclusions:

• Routine evaluation of most coronary artery stents using MSCT is currently not feasible.
• While dedicated convolution kernels improve visualization, scanner hardware and stent material significantly impact image quality and artifact levels.
• Further advancements in MSCT technology are needed for reliable assessment of stented coronary arteries.