Volume visualization of the cervical spine: Principles, techniques, and clinical applications

Multidetector computed tomography (CT) offers important advantages over conventional imaging modalities in the evaluation of the cervical spine. It allows for faster scanning times by a factor of 4 to 16 over conventional CT scanning, which is critical for triaging patients after trauma. Faster scanning times help to eliminate motion artifacts, and the newest multidetector scanners allow for thinner collimation and the ability to achieve an isotropic data set that can be reformatted in any plane without loss of spatial resolution. In addition, three-dimensional volume-rendered reconstructions of images obtained using multidetector scanners can provide additional information in defining the extent of injury or neoplasm, allowing neurosurgeons to see fractures or tumors in any plane, simulating intraoperative views. Three-dimensional volume-rendered images also can significantly reduce streak artifact and beam-hardening artifact that can occur with two-dimensional images in the presence of metal surgical hardware. Three-dimensional volume-rendered multidetector CT represents an advance in CT technology and can help to ensure rapid, accurate evaluation of cervical spine pathology. In this article, the authors demonstrate the utility of three-dimensional volume-rendered images in evaluating cervical spine trauma, neoplasm, and postoperative conditions, with the majority of images presented being obtained with multidetector CT scanners.