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Related Concept Videos

Imaging Studies for Cardiovascular System V: CT01:28

Imaging Studies for Cardiovascular System V: CT

142
Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
142

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Postinterventional Assessment after Stent and Flow-Diverter Implantation Using CT: Influence of Spectral Image

C Zaeske1, T Hickethier2, J Borggrefe2

  • 1From the Institute for Diagnostic and Interventional Radiology (C.Z., T.H., J.B., L.G., M.S., N.A., C.K.) charlotte.zaeske@uk-koeln.de.

AJNR. American Journal of Neuroradiology
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Dual-layer CT imaging with low kiloelectron volt (keV) reconstructions improves stent lumen assessment after endovascular aneurysm treatment. However, image quality did not significantly improve compared to conventional CT scans, and some devices caused artifacts.

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Area of Science:

  • Medical Imaging
  • Radiology
  • Biomedical Engineering

Background:

  • Computed tomography angiography (CTA) is a noninvasive alternative to digital subtraction angiography (DSA) for follow-up after endovascular aneurysm treatment.
  • Stent material artifacts can impede CTA assessability for evaluating aneurysm occlusion and intraluminal narrowing.
  • Flow diverters and conventional stents are used in endovascular aneurysm repair, necessitating reliable imaging follow-up.

Purpose of the Study:

  • To compare the visual assessability of different conventional stents and flow diverters using dual-layer CT.
  • To evaluate the impact of various reconstruction techniques on image quality and artifact susceptibility.
  • To determine the optimal imaging parameters for assessing stent patency and aneurysm status post-treatment.

Main Methods:

  • Four conventional intracranial stents and four flow diverters were implanted in identical aneurysm phantoms.
  • Dual-layer CT images were acquired using conventional and monoenergetic reconstructions at various kiloelectron volt (keV) levels (40-180 keV).
  • Image quality metrics including attenuation alteration, lumen diameter, signal-to-noise ratio (SNR), and subjective radiologist ratings were analyzed.

Main Results:

  • Low keV (40-60 keV) monoenergetic reconstructions showed improved SNR and lumen density compared to high keV reconstructions.
  • Artifact susceptibility varied significantly between stent and flow diverter types, with flow diverters showing increased susceptibility.
  • Subjective assessment of the adjacent aneurysm and overall image quality was not significantly affected by the imaging technique or device type.

Conclusions:

  • Low keV reconstructions enhance stent lumen assessment but do not significantly improve overall image quality compared to conventional CT.
  • Iodine-specific reconstructions can lead to severe artifacts for certain devices and are not recommended.
  • The assessability of the adjacent aneurysm did not show relevant improvement with the tested dual-layer CT techniques.