Imaging of Coronary Stent by Multislice Helical Computed Tomography
A 69-year-old man was admitted to our emergency department with chest pain of 9 hours’ duration. An ECG showed acute ischemia in the inferior and posterior portions of the left ventricular wall. Coronary angiography demonstrated segmental stenoses of the left anterior descending artery (LAD; 50%), left circumflex artery (LCX; 99%), and right coronary artery (RCA; 100%). Fifteen days later, the patient underwent percutaneous transluminal coronary angioplasty and coronary stent placement in the LCX. Three months later, a multislice helical CT was used to assess the stent.
A contrast-enhanced multislice helical CT (LightSpeed Plus, GE) scan was performed using a 500-ms rotation time and 1.25-mm slice thickness during a 35-second breath- hold. The scan was started 23 seconds after commencing injection of 150 mL of contrast material at a speed of 3.5 mL/s. End-diastolic images were reconstructed at 70% RR intervals. Axial images were transferred to a dedicated workstation to create maximum intensity projection, volume rendering, virtual angioscopy, and multiplanar reformation images.
Three-dimensional reconstruction with volume rendering clearly showed the LAD, which was irregular at the proximal portion, the LCX with stent, and the RCA, which was totally occluded at the middle portion (Figure 1). The shape and position of stent were visualized on multiplanar reformation image, but the lumen within the stent segment was not clear (Figure 2). Virtual angioscopy showed the stent to be patent (Figure 3).
The authors thank Li Jie, MD, Zhang Ailian, MD, Yang Yunxia, MS, for their contributions.
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
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