Musculoskeletal Applications of Multichannel Computed Tomography

The challenge of putting a series of articles together about an emerging technology is to have material that is current and meaningful at the time of publication. In the case of multichannel computed tomography, or MCCT, the pace of technology change is measured in weeks and months. Hardware improvements allow increasingly faster scans with increasingly thinner slices; software improvements allow increasingly sophisticated and user-friendly postprocessing systems. In short, the specifics of scanning and imaging techniques in MCCT are a rapidly evolving process.

Nonetheless, certain fundamental aspects of this new technology serve as a foundation for the evolutionary process. It is these principles as they relate to the musculoskeletal system that my colleagues and I highlight in this issue of Seminars. MCCT is a powerful, relatively new imaging tool, and it is changing the way that the musculoskeletal system is imaged.

The first article, “Fundamentals of Multichannel CT,” covers the technological basics behind this powerful new technology. The reader will gain a fundamental understanding of MCCT image formation that can be applied to current systems as well as future-generation MCCT platforms. In the second article, “Application of Multidetector CT in Skeletal Trauma,” basic imaging techniques are discussed in a setting that benefits greatly from this modality. Trauma patients are often difficult to manage and position properly in the scanner, and these patients often cannot remain still. MCCT overcomes these difficulties because of rapid image acquisition and by providing robust multiplanar reformatted images.

“CT Arthrography and Postoperative Musculoskeletal Imaging with Multichannel Computed Tomography” deals with two topics that have greatly expanded the use of CT in imaging of the musculoskeletal system; extremely thin slice acquisition and excellent postprocessing capabilities have made MCCT arthrography the imaging modality of choice for many indications at our institution. The ability to generate high mAs has allowed as never before the evaluation of postoperative patients with orthopedic hardware present.

In the fourth article, “Imaging of the Wrist with Multichannel Computed Tomography,” the ability to acquire essentially isometric data sets and the result of this type of acquisition are explored. Also illustrated in this article is the unsurpassed bony detail of small body parts that may be achieved with MCCT systems.

The final article, “Three-Dimensional Volume Rendering of the Tendons of the Ankle and Foot,” demonstrates a novel use of MCCT to evaluate soft tissues and their relationships to bone. This article gives an insight into the scope and versatility of the work stations that compliment MCCT scanners.

In all, the articles in this issue present a framework for understanding MCCT technology and illustrate some of the types of work that can be done in the musculoskeletal system with these scanners. No compilation of articles of this sort is possible without editorial guidance, and for that guidance my colleagues and I thank David Karasick and Mark Schweitzer. We thank as well our production editor from Thieme Medical Publishers, Erik I. Wenskus, for his assistance. Finally, I thank my colleagues at Indiana University for their insights and efforts in helping to assemble this collection of articles. I am delighted to have been given the opportunity to put this material together, and I hope that the readers of this Seminars issue find the material useful.