Journal article

Publication year: 2021

Pages: 516-523

Journal: American Journal of Neuroradiology

Volume number: 42

Issue number: 3

ISSN: 0195-6108

eISSN: 1936-959X

Open access status: Hybrid

DOI Link: https://doi.org/10.3174/ajnr.A6952

Publisher: American Society of Neuroradiology

Abstract: 

BACKGROUND AND PURPOSE:

CTA provides a noninvasive alternative technique to DSA in the follow-up after endovascular aneurysm treatment to evaluate aneurysm occlusion and exclude intraluminal narrowing after stent or flow-diverter implantation; however, assessability may be impeded by stent material artifacts. The objective of this in vitro study was to compare the visual assessability of different conventional stents and flow diverters as well as different reconstructions of dual-layer CT images.

MATERIALS AND METHODS:

Four conventional intracranial stents and 4 flow diverters were implanted in identical aneurysm phantoms. Conventional and monoenergetic images (40, 50, 60, 90, 120, 180?keV) were acquired to evaluate attenuation alteration, visible lumen diameter, and SNR. Image quality was rated subjectively by 2 independent radiologists using a 4-point Likert scale.

RESULTS:

Low kiloelectron volt (40?60?keV) monoenergetic reconstructions showed an improved SNR and an improved lumen density ratio compared with high kiloelectron volt reconstructions (90?180?keV) and conventional reconstructions, however without reaching significance compared with the latter. Assessment of the adjacent aneurysm and subjective evaluation was not affected by the imaging technique and stent type. Artifact susceptibility varied with the device used and increased among flow diverters.

CONCLUSIONS:

Low kiloelectron volt reconstructions improved the assessment of the stent lumen in comparison with high kiloelectron volt reconstructions. No significant improvement in image quality could be shown compared with conventional images. For some devices, iodine-specific reconstructions led to severe artifacts and are therefore not recommended. There was no relevant improvement in the assessability of the adjacent aneurysm.

Harvard Citation style: Zaeske, C., Hickethier, T., Borggrefe, J., Goertz, L., Dettmeyer, R., Schlamann, M., et al. (2021) Postinterventional Assessment after Stent and Flow-Diverter Implantation Using CT: Influence of Spectral Image Reconstructions and Different Device Types, American Journal of Neuroradiology, 42(3), pp. 516-523. https://doi.org/10.3174/ajnr.A6952

APA Citation style: Zaeske, C., Hickethier, T., Borggrefe, J., Goertz, L., Dettmeyer, R., Schlamann, M., Abdullayev, N., & Kabbasch, C. (2021). Postinterventional Assessment after Stent and Flow-Diverter Implantation Using CT: Influence of Spectral Image Reconstructions and Different Device Types. American Journal of Neuroradiology. 42(3), 516-523. https://doi.org/10.3174/ajnr.A6952