Abstract
BackgroundComplications might occur after great vessel stent implantation in children. Therefore follow-up using imaging is warranted.PurposeTo determine the optimal imaging modality for the assessment of stents used to treat great vessel obstructions in children.Material and methodsFive different large vessel stents were evaluated in an in-vitro setting. All stents were expanded to the maximal vendor recommended diameter (20mm; n = 4 or 10mm; n = 1), placed in an anthropomorphic chest phantom and imaged with a 256-slice CT-scanner. MRI images were acquired at 1.5T using a multi-slice T2-weighted turbo spin echo, an RF-spoiled three-dimensional T1-weighted Fast Field Echo and a balanced turbo field echo 3D sequence. Two blinded observers assessed stent lumen visibility (measured diameter/true diameter *100%) in the center and at the outlets of the stent. Reproducibility of diameter measurements was evaluated using the intraclass correlation coefficient for reliability and 95% limits of agreement for agreement analysis.ResultsMedian stent lumen visibility was 88 (IQR 86–90)% with CT for all stents at both the center and outlets. With MRI, the T2-weighted turbo spin echo sequence was preferred which resulted in 82 (78–84%) stent lumen visibility. Interobserver reliability and agreement was good for both CT (ICC 0.997, mean difference -0.51 [-1.07–0.05] mm) and MRI measurements (ICC 0.951, mean difference -0.05 [-2.52 –-2.41] mm).ConclusionGood in-stent lumen visibility was achievable in this in-vitro study with both CT and MRI in different great vessel stents. Overall reliability was good with clinical acceptable limits of agreement for both CT and MRI. However, common conditions such as in-stent stenosis and associated aneurysms were not tested in this in-vitro study, limiting the value of the in-vitro study.
Highlights
Great vessel stents are commonly implanted in children with congenital heart disease
Good in-stent lumen visibility was achievable in this in-vitro study with both Computed tomography (CT) and Magnetic resonance imaging (MRI) in different great vessel stents
Overall reliability was good with clinical acceptable limits of agreement for both CT and MRI
Summary
Great vessel stents are commonly implanted in children with congenital heart disease. Complications after stent implantation may include in-stent stenosis and aneurysm formation [1]. These complications are relatively rare they require lifelong patient monitoring [2,3]. The use of MRI has been limited, since most large vessel stents were made of stainless steel, which leads to MRI susceptibility artifacts hampering in-stent evaluation. New stent materials like platinum are associated with less susceptibility artifacts and may allow for MRI assessment [9,10]. Complications might occur after great vessel stent implantation in children. To determine the optimal imaging modality for the assessment of stents used to treat great vessel obstructions in children
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