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(Circulation. 2002;106:637.)
© 2002 American Heart Association, Inc.

Images in Cardiovascular Medicine

Imaging of Coronary Stent by Multislice Helical Computed Tomography

Zhao Shaohong, MD; Nie Yongkang, MD; Cai Zulong, MD; Zhao Hong, MD; Yang Li, MD

From the Department of Radiology, General Hospital of PLA, Beijing, China.

Correspondence to Zhao Shaohong, MD, Department of Radiology, General Hospital of PLA, 28 Fuxing Road, Beijing 100853, China. E-mail zhaoshaohong{at}301hospital.com.cn or zhaosh@stanford.edu

A69-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).

View larger version (65K): [in this window] [in a new window]   Figure 1. Coronary CT angiographic 3D volume-rendered image depicting the LAD, LCX and RCA. A, The LCX contains a clearly identifiable stent; the LAD shows irregularity at the proximal portion. B, The RCA shows total occlusion at the middle portion.

View larger version (132K): [in this window] [in a new window]   Figure 2. The position and shape of the stent are evident on the multiplanar reformation image. The enhanced coronary artery distal to the stent indicates patency of the stent.

View larger version (95K): [in this window] [in a new window]   Figure 3. Virtual angioscopy showing patency of the stent.

Acknowledgments

The authors thank Li Jie, MD, Zhang Ailian, MD, Yang Yunxia, MS, for their contributions.

Footnotes

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.

Circulation encourages readers to submit cardiovascular images to the Circulation Editorial Office, St Luke’s Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Shaohong, Z. Articles by Li, Y. Search for Related Content PubMed PubMed Citation Articles by Shaohong, Z. Articles by Li, Y. Related Collections Coronary imaging: angiography/ultrasound/Doppler/CC