OBJECTIVE To evaluate the utility of high-resolution flat-detector computed tomography (HR-FDCT) compared with conventional flat-detector computed tomography (FDCT) for stent placement in symptomatic intracranial atherosclerotic stenosis (ICAS). METHODS We retrospectively reviewed the clinical data of 116 patients with symptomatic ICAS who underwent stent implantation. Images were acquired using conventional FDCT [voxel size = 0.43 mm (isotropic)] and HR-FDCT [voxel size = 0.15 mm (isotropic)]. Immediately after stent deployment, dual-volume three-dimensional (3D) fusion images were obtained from 3D digital subtraction angiography (DSA) and HR-FDCT. The image quality for stent visualization was graded from 0 to 2 (0: not able to assess; 1: limited, but able to assess; 2: clear visualization), and the stent-expansion status ("full," "under-expanded" or "poor apposition") was recorded. RESULTS A total of 116 patients with symptomatic ICAS were treated successfully using 116 stents (58 NeuroformTM EZ, 42 EnterpriseTM, and 16 ApolloTM). The mean pre-stent stenosis was 80.5 ± 6.4%, which improved to 20.8 ± 6.9% after stenting. Compared with FDCT, HR-FDCT improved visualization of the fine structures of the stent to improve the image quality that significantly (mean score: 1.63 ± 0.60 vs. 0.41 ± 0.59, P < 0.001). In 19 patients, stent under-expansion (n = 11) or poor apposition (n = 8) was identified by HR-FDCT but not by conventional FDCT. After balloon dilatation, stent malapposition was shown to have improved on HR-FDCT. None of the 19 patients with stent malapposition experienced short-term complications during hospitalization or had in-stent stenosis at 6-month follow-up. CONCLUSION High-resolution flat-detector computed tomography (HR-FDCT) improves visualization of the fine structures of intracranial stents deployed for symptomatic ICAS compared with that visualized using conventional FDCT. High-resolution flat-detector computed tomography improves assessment of stent deployment and could reduce the risk of complications.

中文翻译：

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高分辨率平面探测器计算机断层扫描在颅内动脉粥样硬化性狭窄支架植入中的应用。

目的 评估高分辨率平面探测器计算机断层扫描 (HR-FDCT) 与传统平面探测器计算机断层扫描 (FDCT) 在症状性颅内动脉粥样硬化狭窄 (ICAS) 支架置入中的效用。方法回顾性分析116例有症状的ICAS患者接受支架植入术的临床资料。使用常规 FDCT [体素大小 = 0.43 毫米（各向同性）] 和 HR-FDCT [体素大小 = 0.15 毫米（各向同性）] 获取图像。支架部署后，立即通过 3D 数字减影血管造影 (DSA) 和 HR-FDCT 获得双体积三维 (3D) 融合图像。支架可视化的图像质量从 0 到 2（0：无法评估；1：有限，但能够评估；2：清晰的可视化）和支架扩张状态（“完全” “扩展不足”或“并列不良”）被记录下来。结果 共有 116 名有症状的 ICAS 患者使用 116 个支架（58 个 NeuroformTM EZ、42 个 EnterpriseTM 和 16 个 ApolloTM）成功治疗。平均支架前狭窄为 80.5 ± 6.4%，支架后改善为 20.8 ± 6.9%。与 FDCT 相比，HR-FDCT 改善了支架精细结构的可视化，显着提高了图像质量（平均分：1.63 ± 0.60 vs. 0.41 ± 0.59，P < 0.001）。在 19 名患者中，HR-FDCT 发现支架扩张不足 (n = 11) 或贴合不良 (n = 8)，但常规 FDCT 未发现。球囊扩张后，HR-FDCT 显示支架贴壁不良有所改善。19 名支架贴壁不良患者在住院期间均未出现短期并发症或在 6 个月的随访中出现支架内狭窄。结论 与使用传统 FDCT 的可视化相比，高分辨率平面探测器计算机断层扫描 (HR-FDCT) 改善了为症状性 ICAS 部署的颅内支架的精细结构的可视化。高分辨率平面探测器计算机断层扫描改善了对支架展开的评估，并可以降低并发症的风险。