MDCT pulmonary angiography: Image processing tools

Virtual pulmonary arterioscopy in pulmonary embolic disease

16 slice multidetector CT provides virtual endoscopic views of the inside of arteries, or any other hollow structures. This is performed non-invasively using post-processing of three-dimensional isotropic image data sets, acquired during standard CT examinations. These virtual endoscopic views are simultaneously correlated with the standard multiplanar reconstructions, with the ability to navigate a virtual camera through the hollow structure under study. Normal and abnormal volume rendered images of the pulmonary arteries are presented in correlation with the multiplanar reformats. The abnormal images show the volume rendered appearances of acute and chronic pulmonary embolic disease. It is also postulated that this technique has a problem solving role in the differential diagnosis of chronic mural emboli from extravascular structures such as adjacent lymph nodes or bronchiolar impaction. This technique may also have a role in medical education, providing clinicians and medical students with interactive three-dimensional representations of disease processes.

Thoracic CT Performance and Interpretation in the Multi-Detector Era

Multi-detector CT (MDCT), in particular isotropic or nearly isotropic MDCT, changes the way in which imagers perform and interpret studies of the thorax. The speed of data acquisition enables new clinical applications of MDCT in the areas of angiography and dynamic perfusion. Cardiac gating software is available, and CT studies of the heart and coronary arteries are now feasible. This review, however, focuses on the impact of MDCT on the routine practice of thoracic imaging, rather than on newer specific MDCT applications. The topics of scan performance and interpretation are related, and MDCT changes each of these areas when compared with the era of axial CT.