Surface imaging from computerized tomographic scans.

A series of computer programs were created to display digital data obtained by the computerized tomographic (CT) scanner in a format readily comprehensible to the nonradiologist physician. The software requires no hardware beyond the CT scanner itself, is efficient in computational time and storage, and requires no operator intervention. The program manipulates standard CT axial data into images that simulate photographs of skin, muscle, or bone surfaces from a variety of perspectives. While the images themselves are planar, the surfaces they display are three dimensional. Portions of the images can be made transparent to permit viewing of previously concealed surfaces. Soft tissue and osseous surfaces may be superimposed to assist the localization of deep pathologic processes. Although the program was created to facilitate craniofacial reconstructive surgery, it has now been applied in over 150 patients for the evaluation of intracranial tumors, head and neck malignancies, cervical spine injuries, pelvic fractures, and deformities of the hands and feet. This ability to provide the surgeon with images that allow direct visualization of anatomic details has reduced operative time and improved surgical results in our management of congenital and acquired deformities.