頭頸部主幹動脈ステント留置術後のヘリカルCTによる評価―血管造影所見との比較検討

Comparison of the Findings of Multislice CT and Angiography: after Stenting for Supraaortic Arteries

　Ⅰ．はじめに

頭頸部主幹動脈に対するステント留置術後の問題点として再狭窄がある．非侵襲的にステント留置後の再狭窄や内膜過形成，血栓形成を評価する方法として頸部エコー，MRAがあるがいずれも欠点や評価の限界がある^2,4,5,7-9)．今回，頭頸部主幹動脈ステント留置術後にヘリカルCTで評価した症例に対し，同時期に行った脳血管撮影所見と比較検討を行った．

　We compared the findings of multislice computed tomography (MSCT) with angiography after stenting for supraaortic arteries. Twelve cases that underwent both MSCT and angiography were evaluated. In 4 cases,stenotic findings were shown by neither MSCT nor angiography. Lumen diameters measured by MSCT tended to be shorter than those measured by angiography. In-stent stenosis evaluated by MSCT was found in 6 cases,and all of them revealed low density areas in the inner stent lumen. In 4 of them,intimal hyperplasia was indicated by angiography,but in 2 of them,unexpectedly,no stenotic findings were found by angiography. In one case,using MSCT the part two stents partially lying over one another revealed severe artifact in the inner stent lumen,but no stenosis was found by angiography. In 2 cases,unevenly spread extra-stent space was found,but that was not revealed by angiography. We conclude that MSCT is useful to evaluate lumen diameter,in-stent intimal hyperplasia,in-stent thrombus,and extra-stent space.