3D CT Angiography

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.

Multislice CT angiography: a practical guide to CT angiography in vascular imaging and intervention

The development of multidetector CT (MDCT) has revolutionized CT angiography (CTA). Not only are new techniques now in the remit of CTA, but all the studies previously performed on single slice or helical CT can now be done with better resolution. The advantage of MDCT relevant to CTA is the ability to acquire high resolution, near isotropic data sets in a shorter acquisition time. Also important is the ability to achieve a longer scanning range in the arterial phase, which has seen the introduction of CTA of the peripheral arterial system. Image processing techniques have also progressed rapidly, with simplification of a previously cumbersome process. The high spatial resolution and relatively non-invasive nature make MDCT angiography a strong and serious competitor to established vascular imaging techniques. The implication is that traditional diagnostic pathways for evaluation of the vascular system have changed.

MDCT pulmonary angiography: Image processing tools

The postprocessing of multidetector row computed tomography (MDCT) data sets is best termed "volume interrogation." Most techniques are best applied as problem-solving tools rather than as preset protocols, and radiologist involvement is essential. The ability to interact with an isotropic or nearly isotropic data set in near real-time is a tremendous advance, but is one that radiologists must rapidly embrace and master. This review begins with a discussion of the basic postprocessing tools relevant to the analysis of the pulmonary vasculature and proceeds to illustrate the clinical application of these techniques to the MDCT of acute and chronic thromboembolic disease. It is clear that in the era of MDCT, axial image review alone is rapidly becoming not only impractical, but also suboptimal. Reformatted images are also beneficial as communication tools for our referring colleagues and can enhance the role of the radiologist as part of the clinical team.

CT and MR imaging of the thoracic aorta: current techniques and clinical applications

Disease of the thoracic aorta can present with a broad clinical spectrum of symptoms and signs. The accepted diagnostic gold standard, selective digital subtraction angiography, is now being challenged by state-of-the-art CT angiography (CTA) and MR angiography(MRA). Currently, in many centers, cross-sectional imaging modalities are being used as the first line of diagnosis to evaluate the cardiovascular system, and conventional angiography is reserved for therapeutic intervention. Understanding the principles of CTA and MRA techniques is essential to acquire diagnostic images consistently. This article reviews current CTA and MRA methods used in the evaluation of thoracic aortic disease.

Eight-channel multidetector computed tomography: unique potential for pediatric chest computed tomography angiography

This case report of a possible aortic pseudoaneurysm after coarctectomy in a 12-month-old boy illustrates the unique considerations when performing pediatric cardiovascular CT angiography in young children. With newer (8-channel) multidetector technology, many of the complexities of performing diagnostic angiography, including sedation, breathing artifact, and intravenous contrast material administration, can be reduced or eliminated.

CT angiography of the arterial system

CTA has become an important diagnostic tool in the evaluation of vascular diseases in virtually all parts of the body. Whereas CTA is able to provide images depicting exquisite anatomic detail, careful scanning technique and selection of scan parameters are critical for high quality studies. The choices to be made when prescribing a scan can seem daunting at first, but if one applies the principles outlined previously, CTA can be a relatively easy, fast, and safe diagnostic technique that is effective in the majority of patients with vascular disease.