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In Vivo Assessment of Coronary Stents With 64-Row Multidetector Computed Tomography: Analysis of Metal Artifacts

Papini, Giacomo D.E. MD; Casolo, Filippo MD; Di Leo, Giovanni DrSci; Briganti, Silvia MD; Fantoni, Cecilia MD; Medda, Massimo MD; Inglese, Luigi MD; De Ambroggi, Luigi MD; Sardanelli, Francesco MD

Journal of Computer Assisted Tomography: November/December 2010 - Volume 34 - Issue 6 - pp 921-926
doi: 10.1097/RCT.0b013e3181ddbbc0
Cardio-Thoracic Imaging

Objective: To evaluate stent-induced artifacts by 64-row multidetector computed tomography (MDCT).

Methods: We studied 26 stented patients with MDCT before conventional coronary angiography (CCA). The CT values were measured. Stents were classified as occluded, with significant stenosis, with nonsignificant stenosis, or patent. For the patent stents, mean in-stent and out-stent CT values were compared; stents 3 mm or smaller were compared with stents larger than 3 mm. Multidetector CT was compared with CCA.

Results: We analyzed 42 stents. At CCA, 34 stents were patent, 5 were nonsignificantly stenosed, 1 was significantly stenosed, and 2 were occluded. At MDCT, 33 of 34 patent stents, 2 occluded stents, and 1 stent with significant stenosis were correctly diagnosed; nonsignificant stenoses were undetected, 1 patent stent was misdiagnosed as occluded (κ = 0.727). The out-stent CT value was lower than in-stent CT value both in stents 3 mm or smaller (P = 0.001) and stents larger than 3 mm (P < 0.001). The in-stent CT value of stents 3 mm or smaller was higher (P = 0.011) than that of stents larger than 3 mm.

Conclusions: Metal artifacts cause overlooking of nonsignificant stenosis.

From the *Scuola di Specializzazione in Radiodiagnostica, Facoltà di Medicina e Chirurgia, Università degli Studi di Milano; †Radiology Unit, Casa di Cura La Madonnina; ‡Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese; §Scuola di Specializzazione in Scienze dell'Alimentazione, Facoltà di Medicina e Chirurgia, Università degli Studi di Milano; ∥Interventional Cardiology, IRCCS Policlinico San Donato, San Donato Milanese; ¶Dipartimento di Scienze Medico-Chirurgiche, Università degli Studi di Milano, San Donato Milanese; and #Cardiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.

Received for publication December 16, 2009; accepted March 3, 2010.

Reprints: Francesco Sardanelli, MD, Department of Medical and Surgical Sciences, University of Milan School of Medicine, and Radiology Unit, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy (e-mail: francesco.sardanelli@unimi.it).

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