Illustrative cases
Case 1
For vessels with a certain degree of curvature,
it becomes impossible to view the entire vessel lumen in a thin traditional MPR slice,
as can seen below. Also rotating along the center line is a very cumbersome task for such traditional MPR sliced views of curved vessels.
Fig. 3: Tradition MPR slice is unable to depict a cross-sectional view of the vessel lumen along the entire center line.
References: NEURI center, Department of NRI, Bicêtre University hospital Paris, France
The CMPR technique alows to inspect the vessel lumen along its entire legnth at once,
as shown below (for the same stent).
It can be easily rotated around its center line.
In this case the CMPR revealed that the stent was distally underdeployed,
while the proximal end was not fully touching the vessel wall.
Both effects have been corrected by ballooning the deployed stent.
It should be noted that the CMPR visualization may stretch or compress structures outside the vessel,
such as is the case with the aneurysm below.
Fig. 4: The CMPR view allows to inspect the deployment of the stent along the entire lumen at once.
References: NEURI center, Department of NRI, Bicêtre University hospital Paris, France
Case 2
In another case the CMPR method (depicted below) clearly showed that the proximal part of the stent was not properly touching the vessel wall,
which was corrected by balloon inflation.
Fig. 5: The CMPR visualization enables an easy and complete assessment of the stent deployment.
References: NEURI center, Department of NRI, Bicêtre University hospital Paris, France
The CMPR after ballooning clearly shows the improved proximal deployment:
Fig. 6: CMPR visualization after ballooning.
References: NEURI center, Department of NRI, Bicêtre University hospital Paris, France
Overall scores
The traditional MPR visualization method scored on average 2.8 out of 5 (lower is better) with a standard deviation of 0.97 on ease-of-use and 2.9 out of 5 (stddev = 1.08) on assessment of stent apposition,
while the CMPR visualization method scored on average 1.8 out of 5 (stddev = 1.06) on ease-of-use and on average 1.3 out of 5 (stddev = 0.62) on assessment of stent apposition.
|
Ease of use |
Assessment of stent apposition |
|
Traditional MPR |
Curved MPR |
Traditional MPR |
Curved MPR |
Average |
2.8 |
1.8 |
2.9 |
1.3 |
Std dev |
0.97 |
1.06 |
1.08 |
0.62 |