MDCT pulmonary angiography: Image processing tools

The postprocessing of multidetector row computed tomography (MDCT) data sets is best termed "volume interrogation." Most techniques are best applied as problem-solving tools rather than as preset protocols, and radiologist involvement is essential. The ability to interact with an isotropic or nearly isotropic data set in near real-time is a tremendous advance, but is one that radiologists must rapidly embrace and master. This review begins with a discussion of the basic postprocessing tools relevant to the analysis of the pulmonary vasculature and proceeds to illustrate the clinical application of these techniques to the MDCT of acute and chronic thromboembolic disease. It is clear that in the era of MDCT, axial image review alone is rapidly becoming not only impractical, but also suboptimal. Reformatted images are also beneficial as communication tools for our referring colleagues and can enhance the role of the radiologist as part of the clinical team.