Techniques for performing multidetector-row computed tomographic angiography

The introduction of multidetector-row computed tomography (CT) scanners has substantially improved the quality and ease of performing CT angiography. CT angiography is a robust method of volumetric vascular imaging that offers benefits over conventional angiography. As CT angiography has become a mainstream examination in many radiology departments, a discussion of techniques toward optimizing CT angiography performed with multidetector-row CT scanners is important. Key principles for optimizing spiral CT acquisition are discussed, and an explanation of multidetector-row CT principles germane to peripheral vascular imaging is presented. A discussion of contrast medium administration strategies ensues, with attention toward injection protocol and bolus timing. An overview of 3-dimensional visualization techniques is subsequently presented, followed by some general rules for CT angiographic interpretation. The article concludes with anatomically directed protocol considerations for the carotid and intracranial circulation, thoracic aorta, pulmonary arteries, abdominal aortoiliac system, renal arteries, and lower extremity arterial inflow and run-off.