Image Quality of Multisection CT of the Brain: Thickly Collimated Sequential Scanning versus Thinly Collimated Spiral Scanning with Image Combining

G.J. den Heeten BACKGROUND AND PURPOSE: Routine CT of the brain is traditionally performed with sequential CT. We assessed whether sequential CT can be replaced with thinly collimated multisection spiral CT without loss of image quality. MATERIALS AND METHODS: An observer study was conducted using data from 23 patients who were scannedwith both a sequential (collimation, 4 5mm) and a spiral technique (collimation, 4 1mm; pitch, 0.875). Each sequential image was registered with 4 combined spiral CT images at 1.2 mm distance. Two neuroradiologists blindly scored 232 image pairs on 6 aspects: streak artifacts, visualization of brain tissue near skull, visualization of hypoattenuated lesions, gray/white matter differentiation, image noise, and overall image quality. A 5-point scale (range, 2 to 2) was used to score the preferences. The 23 pairs of complete scans were scored likewise. In this case, no registration was performed. RESULTS: Virtually all mean scores were positive (ie, showed a preference for the spiral technique). For the comparison of image pairs, the preferences with respect to streak artifacts (mean score, 1.36), visualization of brain tissue near the skull (mean score, 0.69), and overall image quality (mean score, 0.95) were significant (P .001). With respect to visualization of hypo-attenuated lesions, image noise