Image reconstruction & artifacts

Filtered back projection vs. iterative reconstruction, the standard reformats (MPR / MIP / MinIP / CPR), and the four artifacts every reader needs to recognize.

The post-processing toolkit — what each reformat is best for.

Images come out of one of two algorithm families:

  • Filtered Back Projection (FBP). Analytical, fast, the historical default.
  • Iterative Reconstruction. Dramatically lower image noise at the same dose — enabling lower kV/mA protocols.

Standard reformats:

  • MPR — Multiplanar Reformatted images
  • MIP — Maximum Intensity Projection (tracks bright vessels)
  • MinIP — Minimum Intensity Projection (visualizes valves / thrombus)
  • CPR — Curved Multiplanar Reconstruction (bends a vessel into one straight plane)

1 Common artifacts

  • Motion (stepoff) artifact. A break or “step” in the vessel due to cardiac motion. Fix: reconstruct at a different cardiac phase.
  • Breathing artifact. Unlike stepoff, breathing artifacts will noticeably misalign the sternum as well as the heart. Fix: rescan.
  • Beam hardening & streak. Caused by extremely dense materials (calcium, pacemaker leads) absorbing all low-energy photons. Appears as dark hypoattenuated spots and bright radial streaks.
  • Blooming. Calcium volume averaging makes bright plaques visually “bloom,” causing readers to overestimate stenosis severity. Fix: thinner slices, wider windowing, sharper kernels.
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Patient prep & appropriate use