How to open a disk with MRI and CT scans? List of the best programs.

Computed tomography (CT) allows you to most accurately diagnose the condition of the patient’s oral cavity. That is why this procedure must be done before implantation. Only based on the results of such diagnostics can the dentist make a conclusion whether implantation is indicated or, conversely, contraindicated for a particular patient.

CT allows you to obtain a three-dimensional image of the jaw, and in great detail. This is a kind of successful alternative to an x-ray. In dentistry, spiral or multispiral dental tomographs specially created for this purpose are used. They scan tissues and transmit data to a monitor.

Advantages of computed tomography

The results of computed tomography make it possible to detect any pathologies in the oral cavity at the earliest stage of their development. Thanks to this, treatment can be prescribed on time and, accordingly, proceed faster than with an advanced problem. For successful dental implantation, three-dimensional photographs are simply necessary for the dentist; this is the only way to choose an error-free option for installing implants. Statistics show that in 65% of cases of implant failure, dentists did not have three-dimensional photographs of the patients’ jaw bones. On the other hand, if such images are available, successful implantation is observed in 98% of cases.

Indications

Determining whether a patient has indications for this tomography is usually determined by a dentist, oral surgeon or orthopedist-traumatologist. Computed tomography of the jaw is primarily intended to identify bone diseases and pathologies of the maxillofacial area, including:

injuries of the upper and lower jaw
dislocations and subluxations;
osteomyelitis
osteonecrosis
osteoarthritis and osteoarthritis.

Computed tomography data will additionally be able to show some dental defects and dentition anomalies, bone cysts. Tomograms can be used to first approximate the condition of the temporomandibular joint, but its pathologies are better visible on MRI of the temporomandibular joint. In the field of maxillofacial surgery, MSCT is used to create implants and maxillofacial structures.

Benefits of CT

Minimum X-ray exposure. CT scan is indicated even for young children.
Diagnostics takes from 8 seconds to 5 minutes.
There is no need to decipher the diagnostic result.
The highest quality and resolution of images.
Adjustable image contrast allows you to reveal the smallest details.
The ability to study the problem area in three planes.
Ability to change the scale of the image or part of it.
The ability to see the location of nerves and thereby optimally select places for bone drilling.
The ability to quickly make copies of a photo.
The ability to detect complications invisible to the eye.

Computed tomography is a completely painless procedure. It does not even cause the slightest discomfort in the patient. Depending on the type of tomograph, diagnostics can be performed while the patient is sitting, lying, or standing. No preliminary preparation is required to carry it out. A computed tomography scan can be done even when the patient comes only for a consultation. Pictures can be received instantly. Computed tomography is important for both the patient and the dentist; there is no more accurate diagnosis.

MicroDicom Viewer

Free program

MicroDicom Viewer is a free program for non-commercial use that allows you not only to open, but also to create DICOM files based on individual images. The application is small in size (5 MB), it contains the most popular tools for working with DICOM images, and has an intuitive user interface.

Main functions of MicroDicom Viewer

In terms of DICOM image types supported by MicroDicom Viewer, the program is a complete analogue of the previous application. As with RadiAnt DICOM Viewer, .DCM files, folders with DICOM images and metadata, and ZIP archives can be used as source data. For convenience, the function of quickly reading pictures from CD/DVD discs has been implemented. It is also possible to install a portable version of the program on a disk or USB drive.

Among the functionality and features of MicroDicom Viewer, we note:

Adjusting brightness and contrast
Opening multiple images in one window (in different internal windows).
Zoom, pan and scroll.
Pivot and rotation operations.
Tools for measuring and creating annotations/notes - ruler, rectangle, ellipse, angle, arrows, creating hidden areas, text placement, Cobb angles, open and closed polygon lines, etc.
Calculate mean, median, minimum and maximum values with standard deviations displayed.
Measuring tissue density in Hounsfield units.
Special "Cine Loop" function for displaying ultrasound or angiographic images in real time.
Work in full screen mode.
Shows or hides the DICOM tags of the selected image.
Option to display only selected meta tags.
Customizable toolbars to improve efficiency and productivity.
Applying filters to images - blur, sharpen, morphological transformation and others.
Export DICOM to graphic (JPEG, BMP, PNG, GIF and TIFF) and video formats (WMV, AVI).
Export meta tags from DICOM files to a CSV tabular file.
Export

MicroDicom Viewer can also be used as a PACS client to search and download DICOM images from remote servers using the C-ECHO, C-FIND, C-MOVE, C-GET and C-STORE network protocols.

Disadvantages of Computed Tomography

Alas, this seemingly completely harmless procedure has its drawbacks. They consist in the fact that CT has a number of contraindications. These include the following reasons:

an allergic reaction to a contrast agent that is used to pre-treat the patient’s oral cavity;
pregnancy at any stage;
breastfeeding a baby;
the impossibility of diagnosing excessively active young children;
panic fear of closed spaces;
diabetes;
kidney diseases;
thyroid diseases.

The introduction of a contrast agent into the oral cavity allows you to obtain the highest quality image of the oral cavity. However, as a last resort, you can do without this, which experienced dentists sometimes do.

A CT scan of the oral cavity can be done no more than twice a year. Moreover, over the next year it is necessary to refrain from this procedure.

What determines the radiation dose during CT?

The amount of radiation a person receives during a tomography depends on three main factors:

Scan area. It's not about whether it will be a targeted shot or a panoramic shot, but about the part of the body that is to be examined. It has been scientifically proven that individual tissues of the body react differently to exposure to x-rays. One of the smallest doses is obtained when examining the dental system.
Scan time. The time required to obtain CT data is taken into account. The use of cutting-edge equipment makes it possible to reduce the exposure time to X-rays to a few milliseconds.
Type of equipment. Since tomographs are used in different fields of medicine and for different purposes, they are set to a specific time and intensity of radiation. High-field tomographs, better known as MRI, are considered the most powerful. And small-sized dental (intraoral) portable scanners are gentle.

Manufacturers of medical dental equipment know that CT scanning of teeth and jaws is required more often than tomography of other organs. That is why the devices used in modern clinics provide the minimum possible radiation exposure to the body, equal to approximately 0.039-0.06 mSv. This allows not only to repeat tomographic studies several times a month, but also to carry out diagnostics that are as harmless to health as possible, even for children.

How is a tomographic image taken?

A three-dimensional dental tomograph consists of a scanner and a computer. Scanning of the oral cavity is performed using very weak x-rays.

Currently, the industry produces two types of tomographs for dentistry. Tomographs of the first type have a scanning device in the form of a cylinder, through which a table with the patient moves. Tomographs of the second type are equipped with a head stand. The stand is installed on the rotating part of the device. If the first type of tomograph is universal, then the second is designed specifically for the needs of dentistry.

Both types of tomographs work on the same principle. The scanner takes from two hundred to six hundred images of the patient’s oral cavity within one hundred seconds. All of them are sent to the computer in electronic format. The program installed on it analyzes the images and produces an accurate image of the area under study. A three-dimensional image is formed by superimposing layers of different thicknesses on top of each other. Each such layer is separately saved as a DICOM file and can be examined separately.

The tomographic diagnostic procedure itself is not at all burdensome and is done in the following sequence.

The patient is freed from all metal objects that he has with him.
The patient places his chin on a support.
The patient remains completely motionless for several seconds.

That's the whole procedure. If the diagnosis requires the administration of contrast, the patient must not eat or drink anything for 4 hours before the diagnosis.

RadiAnt DICOM Viewer

Shareware

RadiAnt DICOM Viewer is a program that specializes exclusively in viewing DICOM medical images. The application can be used free of charge for 30 days without functional limitations.

Supported DICOM image types

The RadiAnt DICOM Viewer program is capable of opening both DCM files and folders with DICOM images, incl. archived in ZIP format. The application supports many types (modalities) of DICOM images obtained during various medical studies. In addition to computed tomography (CT) and magnetic resonance imaging (MRI), this also includes:

Radiography (CR/CR)
Gamma camera, radionuclide diagnostics (RND)
Positron emission tomography (PET-CT)
Mammography (MG)
Ultrasound diagnostics (ultrasound)
Digital subtraction angiography (DSA)

RadiAnt DICOM Viewer supports monochromatic and color, static and dynamic, compressed and uncompressed images. Thus, the program allows you to view images obtained from almost any modern medical equipment and diagnostic devices of previous generations.

RadiAnt DICOM Viewer Tools and Features

The RadiAnt DICOM Viewer application provides users with the following set of tools for working with images:

Zooming and panning.
Rotate 90 and 180 degrees, mirror.
Adjust brightness and contrast.
View in negative mode.
Various measuring instruments: circle and ellipse (area, tissue density in Hounsfield units), ruler (segment length), protractor (measurement of normal angles and Cobb angles) and others.
The ability to draw with a pen on top of images, placing arrows and polygonal lines (open and closed).

Among the functionality of RadiAnt DICOM Viewer we also note:

Support for three-dimensional images obtained from modern CT/MRI scanners.
Ability to open multiple DICOM files in one window for easy comparison of studies.
Automatic synchronization of series of images acquired in the same plane.
Creation of a local database of DICOM images with the ability to text search by metadata.
Search and open DICOM images on remote DICOM servers using PACS.
Export DICOM to JPEG and BMP images, as well as WMV video consisting of sequentially switched images.
The ability to record a special RadiAnt DICOM Viewer module onto a CD/DVD, which allows you to open content directly from the media without the need to install the program on your computer.

This is not the entire list of functionality of the RadiAnt DICOM Viewer program.

What exactly does CT help with successful dental implantation?

Computed tomography is not a mandatory procedure when preparing a patient for dental implantation. You can do without it by trusting the experience of the dentist. However, in this case, there is a high probability of unsuccessful implantation. Simply put, there is no complete guarantee that the implant will grow into the bone safely.

Computed tomography allows the dentist to obtain:

comprehensive information on jaw bone density;
a complete picture of existing foci of inflammation and defects in the oral cavity;
an accurate picture of the location of the maxillary sinuses, nerves and blood vessels;
the ability to accurately calculate the size of implants and the optimal depth of their immersion into the bone;
the ability to accurately determine the optimal angle of inclination of the implant in relation to the dentition;
the ability to calculate the maximum permissible mechanical load on the implant.

Agree, each of the listed points is extremely important for successful implantation. Under no circumstances should any of these points be neglected.

Pro Surgical 3D

Free program

Pro Surgical 3D is another free program that specializes in viewing medical images from CT and MRI scanners.

Pro Surgical 3D allows you to quickly view patient images, simplifying the workflows associated with 2D and 3D CT and MRI examinations. The program provides treating physicians with a variety of information to develop optimal treatment plans for patients. And helps patients better understand their health status and treatment options.

Among the functionality and features of the program, we note:

The program is designed primarily for viewing DICOM images from CT and MRI scanners, but it also supports common non-DICOM file formats: NifTi (.nii), Visualization Toolkit (.vtk) and ANALYZE (.hdr).
Ability to import DICOM from PACS (local and online database), CD/DVD, USB and local computer.
Ability to load DICOM images into PACS directly from CD or local computer.
Easy to use search of patient metadata.
Performing 3D reconstruction and volumetric visualization (3D rendering).
Multiplane and oblique cutting.
Instant interactive surface extraction and export to STL and PLY formats.
Simple anonymization and de-identification of patient images.
Adjust the brightness and contrast of images.
Creating and saving screenshots.
Function for parallel comparative assessment of pre- and postoperative scans.
Availability of tools to perform various measurements.

Individual application

Dental implantation is not some cookie-cutter procedure. On the contrary, it requires an exclusively individual approach, since no two identical jaw bones exist in nature.

The key to successful implantation is the complete surrounding of the implant surface with bone tissue. The implantation should be completed without the slightest gap between the bone and the artificial root. This process occurs differently for each person.

The dentist’s task, among other things, is to choose the right place to drill a hole for the implant. In this place, the density of bone tissue should be maximum, but it is far from being the same throughout the entire volume of the jaw.

No less important is the choice of the angle of inclination of the implant. If there is an error, the crown will not fit into the overall shape of the remaining dentition.

The drilling depth must also be calculated as accurately as possible to avoid damaging the nerve.

Without computed tomography data, it is extremely difficult to do all this.

What is dental tomography?

When performing any type of CT scan, the principle of different conductivity of X-ray rays by different tissues of the body is used: cavities, bones, muscles, ligaments, etc. In this case, the rays penetrate through any tissue of the body and are captured using a special detector. After a series of layer-by-layer images, a 3D computed tomography model is built using a computer.

Most often, dental tomography of teeth is prescribed before prosthetics, dental implantation, or surgical intervention on the jaw.

The X-ray method does not provide all the advantages that modern computed tomography can provide. Dental CT allows you to study various features of dentofacial anatomy: the structure of teeth and canals, the condition of the jaw bones.

CT results are indispensable for orthopedists, pediatric dentists, orthodontists, and surgeons. For example, for the most accurate production of any prosthesis, the doctor often needs data on the exact dimensions of the jaw anatomy and the most detailed location of the teeth. Only in this case can the prosthesis be manufactured with maximum comfort for the patient.

If, when using implants, the artificial root is implanted incorrectly (inaccurate dimensions or in the wrong location), then the prosthesis will be uncomfortable for the patient or will quickly fail.

Therefore, CT in many clinics is a mandatory preparatory procedure for any type of dental prosthetics (removable or dentures).

Dental tomography is also indispensable for orthodontists, as it ideally shows the exact location of the teeth. In case of surgical pathologies, this method allows you to fully examine the existing dentofacial injuries in all projections.

Risks and dangers of dental implantation

The most risky is dental implantation in the lateral parts of the upper jaw. This is due to the presence of the maxillary sinuses in this area. The trouble is that after the loss of teeth, these sinuses tend to increase in size. It is almost impossible to find out their size without a computed tomography scan. Problems in the maxillary sinuses can significantly complicate dental implantation in the upper jaw, and therefore diagnosis of the sinuses is done as carefully as possible.

If there is chronic inflammation, tumors, polyps or cysts, dental implantation is not performed until all these problems are eliminated. If this is not done, then the implants in the bone tissue simply will not take root and will be rejected by the body. An opinion on the readiness of the upper jaw for implantation is given by two specialists - a dentist and an otolaryngologist. This approach minimizes the likelihood of implant failure.

Where is the best place to get a dental MRI?

ABC-Medicine, a network of medical clinics for the whole family, offers to visit MRI diagnostic rooms in Balashikha and near the Park Kultury metro station. If necessary, you can make an appointment with a dentist or any other specialist. These two clinics have adult and pediatric departments, modern diagnostic equipment, as well as operating rooms with short-stay wards. If an MRI reveals the need for surgical intervention, you will be able to get all the necessary help right on the spot and at an affordable price. Pay attention to special dental programs - for example, “Annual oral hygiene for children”, which at a low cost will help you save on visits to the dentist and maintain dental health since childhood.

What are the consequences of not having a three-dimensional image?

Refusal to conduct a computed tomography scan can lead to very sad consequences. The fact is that without a three-dimensional image, the dentist makes a decision almost intuitively, and this, of course, is a risk. The consequences may be as follows:

nerve damage;
inflammation of the gums due to uneven load on the implants;
premature wear of the structure;
the likelihood of resorting to treatment for problems with the oral cavity;
risk of re-installation of the implant.

Print CT images

To print an image directly from Syngo fastView

, select this item, select the “Patient” tab in the Main Menu, and in it select the “Print” item. Or select the printer icon in the Tab Menu:

In the window that opens, select your printer (make sure it is connected to your computer and configured first), then click OK. The image that is currently open in the Image Display Window will be printed, that is, if multiplanar reconstruction is selected, three CT images, a 3D model and all axes in the position they are placed will be printed.

To print an image without service information on it, before printing, click on the “Show/Hide Image Text” icon, see the item “Hide service information on the image”

CT scan after implant placement

Many patients have questions about whether a CT scan can be performed after implants, crowns or pins have been installed. This question is asked for a reason. Many people know that when performing an MRI, artificial materials present in the oral cavity create a “phonic” sound and thereby confuse dentists. Nothing like this happens with a CT scan. Moreover, it is advisable to do a computed tomography scan before and after dental implantation. This will allow, firstly, to verify the success of the operation, and secondly, to notice in time possible problems with implantation.

However, if there are metal crowns in the oral cavity, it is better to refuse computed tomography. The fact is that metal interferes with the normal operation of the scanner. As a result, the picture turns out to be of poor quality. The same applies to metal pins.

Features of irradiation during CT and not only

The operation of the tomograph is based on the effect of x-rays. Without knowing all the features of the procedure and equipment, some still believe that dental CT is harmful to health, since the body is exposed to radiation. At the same time, few people remember from a school physics course that a person is exposed to radiation everywhere, even outside the X-ray room, for example:

Outdoors on clear days. The sun is the largest natural source of radiation.
At home, being near switched on household appliances: TV;
refrigerator;
various kinds of gadgets, etc.

In airplane. A person receives small doses of radiation for any flight duration.

To understand what kind of radiation exposure a person receives during a CT scan of the jaw and whether it is harmful, it is worth learning a little more about the radiation itself. It is measured in sieverts (Sv), millisieverts (mSv) and microsieverts (µSv). According to SanPiN standards, the following are safe for a person undergoing preventive medical examinations:

1000 μSv per year for an adult;
300-400 µSv per year for children under 15 years of age.

Taking into account the fact that one x-ray examination is performed with a radiation dose from 2-3 μSv (sighting shot) to 16-18 μSv (panoramic shot of the jaw), it is permissible to take 300-500 targeted shots or 60-70 shots of the jaw per year. These figures reflect average data without reference to any specific type of equipment. But they also show that it is not harmful to the body to receive only a few microsieverts for a detailed diagnostic picture.