Introduction

Article Outline

• Copyright

Angiography is not new. Computerized tomography (CT) is not new. Technology that permits use of CT scanners for imaging of the vascular system is not new. Finally, the fact that great progress in CTA has been made during the past few years is not very surprising. Virtually every imaging technique either improves over time or is replaced by a new technique that has made greater progress.

What, then, is so new and exciting about CT angiography? Without doubt, it is the blistering pace of technological advancement. In turn, these advances have lead to an explosion of new and exciting clinical applications. Every year or two our “state-of-the-art” CT scanners and 3-D workstations are leapfrogged by faster and better models that permit broader use of CTA techniques in new ways. Whereas we were delighted in 4-row multi-detector scanners and modest workstations that could provide renderings of renal arteries and the aortoperipheral run-off circulation several years ago, today a scanner with fewer than 64 rows of detectors and a workstation with under 2 gigabytes of random access memory seem pretty obsolete. Remarkably rapid progress in CT scanners and workstations has propelled coronary artery CTA from dream to reality in short order. The next generation of CT scanners is approaching quickly and will capitalize on technology that will send our 2007 CT scanners to the dustbin of technology long before they are fully depreciated.

The challenge for all imagers and vascular interventionalists is to keep up with the ever-improving CTA advances that enhance our ability to characterize vascular disease. Although this edition of TVIR presents a series of articles that are by no means the definitive or final treatment of CTA, it will hopefully serve as a contemporary review. Following the first article on technical aspects of CTA by Hallett and Fleischmann, a group of review articles explore specific application in aortoperipheral, trauma, extremity bypass, renal, mesenteric, central nervous system, and pulmonary vasculature. The edition concludes with several articles that explore technical and interpretive aspects of coronary artery and cardiac CTA. There’s a lot here, and if analogy is made to the vascular rivers discussed in this edition of TVIR, the reader will find a collection of work that is broad, deep, moving ahead swiftly, and not easily navigated in one passage.

On a final (and somewhat technical) note, this edition of Techniques in Vascular and Interventional Radiology presents not only text but dozens of images. For most of us who read CTA’s on a daily basis, colorful 3-D volume rendered images usually carry only a minor amount of useful diagnostic information. Rather, most of the critical CTA information is found in various gray-scale planar reconstructions. While it would be convenient to claim that this underpins the decision to reproduce many of the colorful images in gray-scale, in fact it was the prohibitive cost associated with printing color images that forced the issue. So while some of the images may not be as colorful as they once were, the content is unchanged. If this isn’t satisfactory and you want to see all color images as they originally appeared, they can be viewed in their original state on-line at www.techvir.com and at www.sciencedirect.com.