Effect of Contrast Concentration,Tube Potential and Reconstruction Kernels on MDCT Evaluation of Coronary Stents: an in Vitro Study |
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Authors: | Gopi Kiran Reddy Sirineni Mannudeep K Kalra Krishna Pottala Sandra Waldrop Mushabbar Syed Stefan Tigges |
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Institution: | (1) Radiology, Emory University School of Medicine, 1364 Clifton Road NE, Atlanta, GA 30322, USA |
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Abstract: | Introduction To evaluate effect of different kVp, reconstruction kernels and contrast concentrations on stent luminal diameter measurements
and luminal contrast attenuation values.
Methods Two metallic coronary stents (2.75 mm and 3.0 mm) were deployed in silicone tubes and tubes were filled with diluted iodinated
contrast (1:20 dilution of Iohexol 350 mg% to achieve an attenuation value of 550 HU at 120 kVp). The tubes were scanned at
80, 100, 120 and 140 kVp. Each scan acquisition was reconstructed using B10f, B25f, B31f, B36f, B41f, B46f, B60f, and B80f
kernels. Scans were repeated using 1:35 contrast dilution (350 HU at 120 kVp). Luminal diameter was measured at mid stent
level for each stent, in datasets acquired at different kVp, contrast concentrations, and reconstruction kernels. Luminal
attenuation values (HU) were measured at the mid stent level and at a distance of 1 cm from the stent entrance within the
tube lumen.
Results kVp did not have a significant effect on the visualization of stent luminal diameter (P > 0.277). The change in kernel significantly affected the difference in luminal HU values at stent and non-stent levels (P < 0.001), with B46f showing the least difference in HU values. The lower contrast concentration (350 HU) showed substantially
less artifactual stent stenosis compared to high contrast concentration (550 HU) (P < 0.001). There was excellent inter-observer agreement for stent luminal diameters and attenuation value measurements (r
2=0.971, P < 0.001).
Conclusions For lower spatial resolution kernels, 120 kVp or 140 kVp provides better estimate of stent lumen. Reconstruction kernels and
contrast concentration (HU) have significant effect on visualization of in-stent luminal diameter and artifactual stenosis.
In clinical practice, B46f kernel and lower contrast enhancement value (∼350 HU) may be optimal for evaluating the stent lumen. |
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Keywords: | Coronary stents CT Artifacts |
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