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DOI: 10.1148/radiol.2381042106
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(Radiology 2006;238:309-320.)
© RSNA, 2006

Technical Developments

Carotid Artery Stent Implantation: Evaluation with Multi–Detector Row CT Angiography and Virtual Angioscopy—Initial Experience1

Darren B. Orbach, MD, PhD, Bidyut K. Pramanik, MD, Julie Lee, BA, Thomas S. Maldonado, MD, Tom Riles, MD and Robert I. Grossman, MD

1 From the Neuroradiology Section (D.B.O., B.K.P., J.L., R.I.G.) and Vascular Surgery Division (T.M., T.R.), New York University Medical Center, 530 First Ave, New York, NY 10016. Received December 13, 2004; revision requested February 15, 2005; revision received February 28; accepted March 17, 2005. Address correspondence to D.B.O. (e-mail: darren.orbach{at}med.nyu.edu).

Approval for this HIPAA-compliant study was obtained from the institutional review board; informed consent was not required for retrospective review of patient studies that had been performed for clinical evaluation. The purpose of this study was to retrospectively compare the accuracy of intrastent luminal diameter, as measured on transverse computed tomographic (CT) angiograms and virtual angioscopic views, with the manufacturer's specifications for phantom diameter and with digital subtraction angiographic (DSA) measurements of stent diameter obtained in patients. Intrastent diameter was measured by using standard and stent-optimized reconstruction kernels with three window settings. Endoluminal virtual angioscopic views of the stent-containing vessels were also generated. Measurements at CT angiography were compared with known specifications for the phantom and with DSA measurements in patients. Erroneous measurements of intrastent diameter occurred when a standard kernel and nonoptimized window settings were used. A set of parameters that minimized error relative to measurements obtained at DSA was also identified. Virtual angioscopy helped demonstrate morphologic aspects of stenosis that were otherwise difficult to appreciate.

© RSNA, 2006




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