Comparison of 3D T1-SPACE and DSA in evaluation of intracranial in-stent restenosis

Br J Radiol. 2021 Feb 1;94(1118):20190950. doi: 10.1259/bjr.20190950. Epub 2020 Dec 1.

Abstract

Objective: In-stent restenosis (ISR) after stenting for intracranial stenosis is a significant issue. This study aimed to evaluate the usefulness of the 3D T1-SPACE technique in the follow-up of patients after stent implantation.

Methods: Fifteen patients with intracranial arterial stenosis were prospectively enrolled 6-8 months after stenting. Digital subtraction angiography (DSA) and 3D T1-SPACE imaging were performed to evaluate the degree of stenosis and the enhancement of the vessel wall. Bland-Altman plots were used to assess the agreement between the two imaging methods, and the Pearson correlation coefficient was calculated as a measure of the linear correlation.

Results: Eight Enterprise stents and seven Wingspan stents were used in 15 patients. The follow-up DSA after 6-8 months showed that the degree of stenosis was 40% (range, 30-72%), and ISR occurred in 4 of 15 (26.7%) lesions. The degree of stenosis assessed using the 3D T1-SPACE imaging technique was 35% (range, 30-75%). All four patients with ISR demonstrated significant enhancement. The Pearson correlation coefficient between the two methods was 0.959 (p < 0.05), and the Bland-Altman plot showed that all data points were within the consistency limits ([Formula: see text] ± 1.96 s).

Conclusion: As a non-invasive imaging modality, 3D T1-SPACE showed great consistency with DSA in measuring the degree of stenosis after intracranial stenting. It may be used as an optional method for detecting ISR.

Advances in knowledge: This study evaluated the usefulness of 3D T1-SPACE technique in the follow-up of patients after stent implantation, which could be used as an optional and non-invasive method in detection of in-stent restenosis.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Angiography, Digital Subtraction / methods*
  • Arteries / diagnostic imaging
  • Cerebral Angiography / methods*
  • Female
  • Follow-Up Studies
  • Graft Occlusion, Vascular / diagnostic imaging*
  • Humans
  • Imaging, Three-Dimensional / methods*
  • Intracranial Arteriosclerosis / diagnostic imaging*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Prospective Studies