Advances in medical technology in the past few years have made it possible for doctors to "see" inside patients without so much as lifting a scalpel. Computer software compiles CT (Computerized Tomography) and MRI (Magnetic Resonance Imaging) scans of a patient's injury to produce a maneuverable, three-dimensional (3-D) image of the problem, allowing the physician to visualize precisely what the problem is and where it is located and decide how it can best be treated - all before any surgery begins.

Our 3-D Imaging Lab was established in 1998 to determine whether patients with abdominal aortic aneurysms could have an endovascular stent graft. We found that 3-D imaging was helpful in presurgical planning for traditional, endolaparoscopic and robotic-aortic surgery as well.

View a series of television videos about 3D Imaging featuring Dr. Martinez.

Major advances in CT scanning technology allow us to acquire 1,000 thin-sliced (highly detailed) images in only a few seconds. Once gathered, this data is sent to a workstation for post-processing by our lab's full-time 3-D technologist, who was trained at Stanford School of Medicine, Radiology Department. Post-processing includes:

• Volume rendering (3-D model in color);
• MIPs (maximum intensity projections), which display calcification on the vessel wall;
• Quantitative analysis of vessel diameters, path lengths, angles, etc.;
• CPR (curved planar reformation) to display the interior of tubular structures such as blood vessels;
• SSD (shaded surface display) for 3-D anatomy;
• Data segmentation (for 3-D volumes) and editing techniques for bone removal and clear vascular visualization;
• Thin or thick slab volumes; and
• Multiplanar reformations and curved planar reformations (very useful in demonstrating areas of stenosis, thrombus or occlusions).

After post-processing the 3-D images are printed on film, and source data and post-processed images are sent to PACS.

Patients who were scanned at an outside facility may be referred to us by their physicians. Referring physicians are sent a hard copy of the final report with results of quantitation along with the 3-D volume-rendered images.