Computed tomography image quality of aortic stents in patients with aortic coarctation: a multicentre evaluation
Sara Boccalini1, Annemarie M den Harder2, Maarten Witsenburg3
1Department of Radiology, Erasmus Medical Center, PO Box 2040, 3000CA, Rotterdam, The Netherlands. s.boccalini@erasmusmc.nl.
Insights
Image quality varies significantly between stent types used for aortic coarctation. Some stents show better computed tomography (CT) imaging and fewer blooming artifacts than others.
Area of Science:
- Cardiovascular Imaging
- Medical Device Technology
- Interventional Cardiology
Background:
- Stents are a common treatment for aortic coarctation.
- Evaluating post-implantation imaging is crucial for assessing treatment efficacy.
Purpose of the Study:
- To assess and compare the computed tomography (CT) image quality of various stent types after implantation for aortic coarctation.
Main Methods:
- Retrospective analysis of contrast-enhanced CT scans from adult and pediatric patients.
- Subjective image quality scoring (1-4 scale) and measurement of stent blooming artifacts (percentage difference).
Main Results:
- Seventy-one stents of six types were analyzed in 35 children and 34 adults.
- Cheatham Platinum stents (most common) showed moderate image quality and significant blooming (34-48%).
- Formula stents exhibited similar blooming (44-55%), while other types had good to excellent image quality with less blooming.
Conclusions:
- Significant variability exists in CT image quality and blooming artifacts among different stent types used for aortic coarctation.
- Stent selection may impact diagnostic imaging accuracy and assessment of treatment outcomes.
Background:
Stents are commonly used to treat aortic coarctation. The objective of this study was to evaluate the post-implantation computed tomography (CT) image quality of different stent types used to treat aortic coarctation.
Methods:
Adult and paediatric patients with stent-treated aortic coarctation who underwent contrast-enhanced CT were retrospectively included from three tertiary care centres. CT scans were subjectively scored for image quality using a 4-point scale (1 = unacceptable; 2 = poor; 3 = good; 4 = excellent). Furthermore, the amount of stent-induced blooming artefacts was measured as the percentage of the difference between outer and inner stent diameters over the outer stent diameter.
Results:
A total of 35 children and 34 adults implanted with 71 stents of six different types were included. The most commonly used stent type was the Cheatham Platinum stent (52 stents, 73%). The subjective image quality of the Cheatham Platinum stents was moderate with a score of 2.0±0.8 (mean ± standard deviation) in children and 2.3±0.6 in adults. The image quality in patients with Formula stents was 2.3±1.2. The Cheatham Platinum stents induced 34-48% blooming, the Formula stents 44-55%. The image quality in patients with the less commonly used Atrium Advanta V12, IntraStent, AndraStent and Palmaz stents was scored 3 (good) to 4 (excellent) with less blooming. The electrocardiographic gating and tube voltage (kVp) did not affect image quality.
Conclusions:
There is a substantial variation in CT image quality and blooming artefacts for different stent types used to treat aortic coarctation.
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