J Korean Med Assoc.  2007 Jan;50(1):18-24. 10.5124/jkma.2007.50.1.18.

MDCT Application in Musculoskeletal Imaging

• Cho J

• KMID: 2184791
• DOI: http://doi.org/10.5124/jkma.2007.50.1.18

Abstract

Multidetector computed tomography (MDCT) has been developed for the purpose of reducing the scan time and enlarging the scan coverage. In benefit of multiple arrays of detectors along with faster gantry, MDCT has now become an inevitable diagnostic tool for various kinds of musculoskeletal diseases. Three-dimensional reconstruction images are the basic method in all kinds of musculoskeletal images. Multiplanar reformat, surface rendering, and maximum intensity projections are frequently used techniques. Occult fractures in complex anatomic regions, joint disease evaluations including internal derangement of the joints, and cartilage lesions can be assessed accurately with MDCT. Indirect intravenous contrast enhanced angiographic images are much improved from the previous version of CT or MRI in terms of differentiating individual phases of contrast filling. MDCT is a 3D-oriented diagnostic tool, and one must acknowledge appropriate scan parameters in order to obtain the best 3D results. MDCT is one of the hottest imaging tool in the field of diagnostic radiology. Sixty-four detector CT is now popular, and 512 and more advanced detectors such as 2-dimensional fat panel CT are expected to appear in the near future. A thorough knowledge on the application of MDCT is necessary in order to use this state-of-the-art imaging equipment efficiently in our daily practice.

Keyword

Musculoskeletal radiology; Multidetector computed tomography; Three dimensional reconstruction imaging diagnosis

MeSH Terms

Cartilage
Fractures, Closed
Joint Diseases
Joints
Magnetic Resonance Imaging
Multidetector Computed Tomography
Musculoskeletal Diseases

Figure

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  Figure 1 Arrangement of detectors of multidetector computed tomography machine of major vendors. The diagram on the left is four slice scanners, and on the right is 16 slice scanner. Minimum 0.625 mm sized detector elements are used in the center of the array

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  Figure 2 Types of three dimensional reconstruction (A) Multiplanar reformat image of mandible reformatted along the curve of axis of mandible. Like panorama view, all mandiblular structures are displayed in one plane (B) Surface rendering image of acetabular fracture. Fracture fragements are visualized efficiently with this technique (C) Maximum intensity projection image of ankle fracture. Evaluation of fracture anatomy is more easy with this view

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  Figure 3 (A) Fracture dislocation is noted in midlumbar spine. Fragment is not clearly seen in plain radiography (B) Sagittal reformat image of the same patient shows posterior displacement of fracture fragment into the spinal canal

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  Figure 4 (A) CT arthrographic image of the knee. Cartilage surface is clearly identified (B) MR image of same patient show metallic artifact due to surgical materials

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  Figure 5 Three plane reformatted image from Isovoxel images. Resolution of images are not so different between axial, coronal and sagittal images

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  Figure 6 (A) Coronal reformat image of ankle with small focal spot. (B) same patient with large focal spot. Image with small focat spot show more clear boundary

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