MSCT AN INTRODUCTION TO A NOVEL TECHNIQUE

Dr. Hazem Abu Zeid YousefLecturer of Radiodiagnosis

Faculty of MedicineAssiut University

INTRODUCTION

The introduction of spiral CT in the early 1990s resulted in fundamental and far-reaching improvement of CT imaging.

For the first time volume data could be acquired without mis-registration of anatomical details, which initiated the development of 3D image processing techniques such as multi-planar reformations (MPRs), maximum intensity projections (MIPs), surface-shaded displays (SSDs) or volume renderings.

As an important application CT angiography (CTA) has been established in clinical practice. As a consequence of increasing clinical demands, single-slice spiral CT with 1-s gantry rotation time soon encountered its limitations.

Larger volume coverage and improved transverse resolution can be achieved by simultaneous acquisition of more than one slice and by a shorter gantry rotation time. The first step towards multi-slice acquisition was a two-slice CT scanner introduced

in 1993 (Elscint Twin). In 1998 all major CT manufacturers introduced multi-slice CT systems which brought about considerable improvements of scan speed, transverse resolution and utilization of the

tube output.

SOME CLINICAL APPLICATIONS OF MDCT

MDCT ANGIOGRAPHY

CEREBRAL ANGIOGRAPHY

THORACIC AORTA

ABDOMINAL AORTA

LOWER LIMBARTERIOGRAPHY

PULMONARY ARTERIES

COMPERHENSIVE MSCT OF THE ABDOMEN

TRIPHASIC LIVER STUDY

HEPATOBILIARY SYSTEM

MDCT UROGRAPHY

NORMAL ANATOMY

NORMAL ANATOMY

FRONTAL (ANTERIOR) VIEW OF VR IMAGES

MIP IMAGE (POSTERIOR VIEW) VR DOUBLE DENSITY IMAGE

(POSTERIOR VIEW)

NORMAL VARIANTS AND CONGENITAL ANOMALIES

NORMAL PAPILLARY BLUSH

PROMINENT RENAL PAPILLA

COMPOUND CALYX

PTOTIC KIDNEY

ECTOPIC KIDNEY

VR IMAGE MIP IMAGE

HORSESHOE KIDNEY

DOUPLEX LEFT COLLECTING SYSTEM WITH ECTOPIC UPPER MOIETY URETER

UROLITHIASIS

CASE (1)

NON ENHANCED CT SHOWING BILATERAL RENAL PELVIS CALCULI WITH MARKED PYELITIS.

ENHANCED CT SHOWING GOOD ENHANCEMENT.

MIP; THE STONES ARE WELL-SEEN WITHIN THE OPACIFIED RENAL PELVIS.

CASE (2)

THICK SLAP MIPBILATERAL RENAL AND UB STONES

CORONAL IMAGESSHOWING MARKED PYELITIS OF THE LEFT KIDNEY

MIP; THE STONES ARE WELL-SEEN WITHIN THE OPACIFIED RENAL PELVIS. MULTIPLE UB STONES.

CASE (3)

ACUTELY OBSTRUCTEDLEFT KIDNEY WITH PERINEPHRIC COLLECTION (FORNICEAL RUPTURE).

CURVED REFORMATSSHOWING 3 LOWER URETERIC STONES.

CASE (4)

CURVED REFORMATLOWER URETERIC STONE

CAUSING MILD HYDRONEPHROSIS

DOUBLE DENSITY VR IMAGETHE STONE IS DEMONSTRATED

AGAINST THE UNDERLYINGBONE

CASE (5)

BILHARZIAL CALCIFICATION OF THE LEFT LOWER URETER WITH LOWER URETERIC STONE.

CASE (6)

CASE (7)

CASE (8)

RENAL INFECTIONS

CASE (1)MULTIFOCAL NEPHRONIA

CASE (2)

OBSTRUCTED INFECTED KIDNEYENLARGED LEFT KIDNEY WITH MARKED STRANDING OF THE

PERINEPHRIC FAT AND OBSTRUCTING PELVIC CALCULUS

DOUBLE DENSITY VR IMAGE SHOWING THE OBSTRUCTING CALCULUS

RENAL SOLs

CASE (1)

NON ENHANCED CT ENHANCED CT

DELAYED FILLING OF CALYCEAL DIVERTICULUM

CASE (2)

SIMPLE (BOSNIAK TYPE I) RENAL CYST

CASE (3)

MULTILOCULAR PARAPELVIC CYST WITH STRETCHING OF THE MAJOR CALYCES

CASE (4)

BOSNIOAK TYPE II CYST WITH THIN CALCIFIED RIM AND INTRACYSTIC SEPTUM

(THANKS FOR THE SUBMILLEMETRIC SLICE THICKNESS)

CASE (5)

INITIALLY HYPERDENSE SIMPLE CYST (BOSNIAK TYPE II)

CASE (6)

BOSNIAK TYPE III CYSTTHICK ENHANCING INCOMPLETE

SEPTUM AND IRREGULAR OUTLINES

CASE (7)

BOSNIAK TYPE IV CYSTTHICK ENHANCING MURAL NODULE

CASE (8)

SOLID PARAPELVIC MASS CLEARLY DEMONSTRATED IN CORONAL IMAGES

CASE (9)

MALIGNANT LOWER POLAR LEFT RENAL MASS WITH ENHANCING MALIGNANT THROMBUS WITHIN THE IVC

AND SECONDARY VARICOSITIES OF THE LEFT TESTICULAR VEIN.

CASE (10)

MALIGNAT SUPRARENAL MASSWITH LIVER METASTASES

DISPLACED LEFT KIDNEY WITH DOUPLEX RIGHT COLLECTING SYSTEM

CASE (10)

URETERS

AS A RULE;MALIGNANT URETERIC NEOPLASMS CHARACTERISTICALLY CAUSE DILATATION OF THE URETER BOTH PROXIMAL AND DISTAL TO THE LESION.

CASE (1)

CASE (2)

CASE (3)

CASE (6)

FIBROVASCULAR POLYP OF THE URETER

URINARY BLADDER

CASE (1)

CASE (2)

EXTRAVESICAL PARARECTAL MASS

CASE (3)

RENAL ARTERY ASSESSMENT

SOME SPECIAL TECHNIQUES

CONTRAST ENEMA

MDCT FISTULOGRAPHY

ASSESSMENT OF POLYTRAUMA

FRACTURE MANDIBLE

FRACTURE CX SPINE

FRACTURE L.S.S.

FRACTURE PELVIS

THANK YOUTHANK YOU