Friedrich Dr. Fuchs

TrueFISP—technical considerations and cardiovascular applications

Magnetic resonance imaging (MRI) using steady-state free precession (SSFP) sequences was described in the early years of MR imaging. However, due to hardware imperfections, these techniques were not robust enough at the time to play any significant role in clinical MRI. More recently, significant hardware improvements became widely available, and the SSFP sequences such as TrueFISP (true fast imaging with steady-state precession) became very popular for a variety of clinical applications due to the distinct improvements in signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). The purpose of this article is to give an overview on the basics of TrueFISP imaging and to demonstrate its potential for current clinical applications with a focus on cardiovascular MRI.

Three-dimensional on-line reconstruction of coronary bifurcated lesions to optimize side-branch stenting.

Treatment of coronary bifurcation lesions is technically challenging. Following advances in stent design, various methods of stent placement in bifurcation lesions (‘‘T,’’ ‘‘Y,’’ ‘‘V,’’ and ‘‘Culotte’’) have been described in the literature, with individual centers reporting satisfactory technical results. However, restenosis rates as high as 60% continue to be reported [1]. Recently, antiproliferative coating of coronary stents has proven to significantly reduce the amount of restenosis found in bifurcation lesions [2]. Of note, in this study, the majority of restenosis occurred at the ostium of the side branch following T-stenting. It was therefore hypothesized that these restenoses might result from inadequate or incomplete coverage of the ostium of the side branch, thereby reducing the efficacy of the drugeluting stent. To date, the most effective strategy to percutaneous therapy of bifurcation lesions needs to be carefully evaluated in randomized studies. Such randomized studies must take into account baseline anatomical differences (e.g., vessel size and bifurcation angle) of bifurcation lesions to individually determine the best strategy for a given bifurcation lesion. Therefore, tools to optimize treatment strategy and stent placement are highly desirable. The present report describes a new software that allows three-dimensional (3D) reconstruction of coronary bifurcation lesions and the individually related quantitative data.