Advanced Computed Tomography Imaging, Workstations, and Planning Tools

Abstract

Multidetector-row computed tomography (MDCT) has now replaced the old “gold standard,” intra-arterial digital subtraction angiography (DSA), for assessing abdominal, thoracic, and cranial vasculature. MDCT raw data are captured in two-dimensional (2D) transverse sections. Therefore, to generate an angiographic display, a three-dimensional (3D) workstation is required. To depict vascular anatomy on the workstation, specific anatomical projections must be created using one or more visualization techniques. The image projections must display the vascular region of interest in the correct viewing planes without being obscured by other vascular territories or noncardiovascular structures. Furthermore, the resultant images must be rendered with the correct window, level, and lighting settings to accurately depict normal anatomy and pathology. The volumetric data acquired enable the acquisition of views from any angle and perspective. MDCT has a superior diagnostic accuracy compared with intra-arterial DSA in characterizing the neck of the abdominal aortic aneurysm, identifying accessory renal arteries, and characterizing renal arterial stenoses.