Optimized intravenous Flat Detector CT for non-invasive visualization of intracranial stents: first results

Eur Radiol. 2011 Feb;21(2):411-8. doi: 10.1007/s00330-010-1931-3. Epub 2010 Aug 14.


Objective: As stents for treating intracranial atherosclerotic stenosis may develop in-stent re-stenosis (ISR) in up to 30%, follow-up imaging is mandatory. Residual stenosis (RS) is not rare. We evaluated an optimised Flat Detector CT protocol with intravenous contrast material application (i.v. FD-CTA) for non-invasive follow-up.

Methods: In 12 patients with intracranial stents, follow-up imaging was performed using i.v. FD-CTA. MPR, subtracted MIP and VRT reconstructions were used to correlate to intra-arterial angiography (DSA). Two neuroradiologists evaluated the images in anonymous consensus reading and calculated the ISR or RS. Correlation coefficients and a Wilcoxon test were used for statistical analysis.

Results: In 4 patients, no stenosis was detected. In 6 patients RS and in two cases ISR by intima hyperplasia perfectly visible on MPR reconstructions of i.v. FD-CTA were detected. Wilcoxon's test showed no significant differences between the methods (p > 0.05). We found a high correlation with coefficients of the pairs DSA/ FD-CT MIP r = 0.91, DSA/ FD-CT MPR r = 0.82 and FD-CT MIP/ FD-CT MPR r = 0.8.

Conclusion: Intravenous FD-CTA could clearly visualise the stent and the lumen, allowing ISR or RS to be recognised. FD-CTA provides a non-invasive depiction of intracranial stents and might replace DSA for non-invasive follow-up imaging.

MeSH terms

  • Aged
  • Blood Vessel Prosthesis*
  • Carotid Stenosis / diagnostic imaging*
  • Carotid Stenosis / surgery*
  • Cerebral Angiography / instrumentation*
  • Equipment Design
  • Equipment Failure Analysis
  • Female
  • Humans
  • Image Enhancement / instrumentation
  • Male
  • Middle Aged
  • Pilot Projects
  • Prognosis
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Stents*
  • Tomography, X-Ray Computed / instrumentation*
  • X-Ray Intensifying Screens*