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Volume-rendered Three-dimensional Spiral CT: Musculoskeletal Applications¹

¹ From the Russell H. Morgan Department of Radiology and Radiologic Science, Johns Hopkins University School of Medicine, Baltimore, Md. Presented as a scientific exhibit at the 1997 RSNA scientific assembly. Received October 28, 1998; revision requested November 23 and received December 30; accepted January 26, 1999. Address reprint requests to E.K.F., Department of Radiology, Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287.

Spiral computed tomography (CT) is a powerful modality for evaluation of the musculoskeletal system, particularly when coupled with real-time, volume-rendering reconstruction techniques. Including volume-rendered spiral CT in routine musculoskeletal imaging protocols can change management in a significant number of cases. In cases of trauma, subtle fractures—particularly those oriented in the axial plane—are better seen on volume-rendered images. Complex injuries can be better demonstrated with volume-rendered images, and complicated spatial information about the relative positions of fracture fragments can be easily demonstrated to the orthopedic surgeons. The use of intravenously administered contrast material allows simultaneous evaluation of osseous and vascular structures within the affected area. Evaluation of suspected infectious or neoplastic disease is also aided by including volume-rendered imaging in the musculoskeletal spiral CT examination. The extent of disease can be thoroughly evaluated with volume-rendered images, and therapeutic planning—be it surgical or medical—is aided by the anatomic information available from volume-rendered images. Postoperative studies in patients with orthopedic hardware also benefit from volume-rendered imaging. Volume rendering eliminates most streak artifact and produces high-quality images on which the relationships among hardware, bones, and bone fragments are well demonstrated.

Index Terms: Bone neoplasms, 40.30 • Bones, infection, 40.20 • Bones, injuries, 40.40 • Computed tomography (CT), helical, 40.12115 • Computed tomography (CT), three-dimensional, 40.12117 • Computed tomography (CT), volume rendering, 40.12117

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