Connecting Radiology | Enabling collaboration and professional development
Multidetector CT for visualization of coronary stents.
Pugliese F, Cademartiri F, van Mieghem C, Meijboom WB, Malagutti P, Mollet NR, Martinoli C, de Feyter PJ, Krestin GP.
Department of Radiology, Erasmus MC, Dr Molenwaterplein 40, 3015 GD Rotterdam, The Netherlands. francesca.pugliese@libero.it
Radiographics. 2006 May-Jun;26(3):887-904.
Whereas the clinical diagnosis of in-stent thrombosis is straightforward, that of in-stent restenosis remains a problem, because although many patients experience chest pain after coronary stent placement, that symptom is secondary to ischemia in only a few. The use of a noninvasive technique to identify such patients for early invasive intervention versus more conservative management is thus highly desirable. Multidetector computed tomography (CT) performed with 16-section scanners recently emerged as such a technique and has overtaken modalities such as electron-beam CT and magnetic resonance imaging as an alternative to conventional angiography for the assessment of in-stent restenosis. The improved hardware design of the current 64-section CT scanners allows even better delineation of stent struts and lumen. The more reliable criterion of direct lumen visualization thus may be substituted for the presence of distal runoff, which lacks specificity for a determination of in-stent patency because of the possibility of collateral pathways. However, the capability to accurately visualize the in-stent lumen depends partly on knowledge of the causes of artifacts and how they can be compensated for with postprocessing and proper image display settings. In addition, an understanding of the major stent placement techniques used in the treatment of lesions at arterial bifurcations is helpful. Copyright RSNA, 2006.
Posted via PubMed for educational and discussion purposes only.
Link to PubMed Reference
Department of Radiology, Erasmus MC, Dr Molenwaterplein 40, 3015 GD Rotterdam, The Netherlands. francesca.pugliese@libero.it
Radiographics. 2006 May-Jun;26(3):887-904.
Whereas the clinical diagnosis of in-stent thrombosis is straightforward, that of in-stent restenosis remains a problem, because although many patients experience chest pain after coronary stent placement, that symptom is secondary to ischemia in only a few. The use of a noninvasive technique to identify such patients for early invasive intervention versus more conservative management is thus highly desirable. Multidetector computed tomography (CT) performed with 16-section scanners recently emerged as such a technique and has overtaken modalities such as electron-beam CT and magnetic resonance imaging as an alternative to conventional angiography for the assessment of in-stent restenosis. The improved hardware design of the current 64-section CT scanners allows even better delineation of stent struts and lumen. The more reliable criterion of direct lumen visualization thus may be substituted for the presence of distal runoff, which lacks specificity for a determination of in-stent patency because of the possibility of collateral pathways. However, the capability to accurately visualize the in-stent lumen depends partly on knowledge of the causes of artifacts and how they can be compensated for with postprocessing and proper image display settings. In addition, an understanding of the major stent placement techniques used in the treatment of lesions at arterial bifurcations is helpful. Copyright RSNA, 2006.
Posted via PubMed for educational and discussion purposes only.
Link to PubMed Reference
Views: 0
© 2024 Created by radRounds Radiology Network.
Powered by
