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New Techniques in CT Angiography¹

¹ From the Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles (M.M.L.); the Department of Radiology (M.M.L., K.A., M.U., W.A.B.) and Computer Graphics Group (F.V.H.), University of Erlangen-Nuremberg, Maximiliansplatz 1, 91054 Erlangen, Germany; Siemens Medical Solutions, Forchheim, Germany (E.K., H.D.); the MeVis Center for Medical Diagnostic Systems and Visualization, Bremen, Germany (T.B.); and the Department of Neuroradiology, Klinikum-Bremen-Mitte, Bremen, Germany (B.F.T.). Presented as an education exhibit at the 2005 RSNA Annual Meeting. Received February 7, 2006; revision requested April 13 and received May 8; accepted May 17. E.K., H.D., and F.V.H. are employees of Siemens Medical Solutions; T.B. receives research support from Siemens Medical Solutions; all other authors have no financial relationships to disclose. Address correspondence to M.M.L. (e-mail: michael.lell{at}idr.imed.uni-erlangen.de).

Computed tomographic (CT) angiography has been improved significantly with the introduction of four- to 64-section spiral CT scanners, which offer rapid acquisition of isotropic data sets. A variety of techniques have been proposed for postprocessing of the resulting images. The most widely used techniques are multiplanar reformation (MPR), thin-slab maximum intensity projection, and volume rendering. Sophisticated segmentation algorithms, vessel analysis tools based on a centerline approach, and automatic lumen boundary definition are emerging techniques; bone removal with thresholding or subtraction algorithms has been introduced. These techniques increasingly provide a quality of vessel analysis comparable to that achieved with intraarterial three-dimensional rotational angiography. Neurovascular applications for these various image postprocessing methods include steno-occlusive disease, dural sinus thrombosis, vascular malformations, and cerebral aneurysms. However, one should keep in mind the potential pitfalls of these techniques and always double-check the final results with source or MPR imaging.

© RSNA, 2006

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