Technical Parameters in Multidetector CT of the Cervical Spine

Ronald M Bilow, MD; O Clark West, MD
Section of Emergency and Trauma Radiology
Department of Radiology
The University of Texas Health Science Center Houston

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Purpose: This educational exhibit is designed to illustrate important technical parameters in the use of multidetector CT for cervical spine imaging.

Methodology: Through a display of images, this poster demonstrates how variations in imaging protocol using multidetector CT can affect the radiologist's ability to detect and/or characterize injuries of the cervical spine.

EFFECT ON IMAGE QUALITY

RECONSTRUCTION ALGORITHM

Patient A
1.25 Standard Algorithm Axial Images 2.0 mm Sagittal Reformats					Same Raw Data Same Window Settings 1.25 mm Bone Algorithm Axial Images 2.0 mm Sagittal Reformats
Standard Algorithm Results in Decreased Image Noise and Increased Bone Detail

 

PITCH SELECTION
Pitch 0.75				Pitch 1.5
Patient B			Patient C
120 kVp 250 mA			120 kVp 250 mA
Patient D			Patient E
120 kVp 250 mA			120 kVp     410 mA
Higher Pitch Results in Increased Artifact, Which Can Be Partially Corrected by Increasing mA

 

EFFECT ON DIAGNOSIS

SLICE THICKNESS SELECTION

 

Patient F		Patient G
C2 Hyperextension Teardrop Fracture Seen on 1.25 mm Axial Images (arrows), Lost to Volume Averaging on 2.5 mm Axial Images		Right C6 Superior Articular Facet Fracture (arrows) is Difficult to see on 1.25 mm Reformats, but is Readily Visible on 3.0 mm Reformats

REFORMATION ANGLE
Patient H
Technician Applied Reformation Angle	Reformation Angle Adjusted to True Coronal Plane for Area of Interest
Angle of Reformatted Images Should be Optimized For Region of Interest Note the Type 2 Dens Fracture (arrows).