Clinical potential of retrospective on-demand spectral analysis using dual-layer spectral detector-computed tomography in ischemia complicating small-bowel obstruction.

We describe a case of ischemia complicating acute small-bowel obstruction in which retrospective on-demand spectral analysis using dual-layer spectral detector computed tomography (CT) provided a higher degree of confidence pertaining to the diagnosis. Dual-layer spectral detector CT enables retrospective on-demand spectral analysis, including virtual monochromatic imaging, iodine mapping, and determining the effective atomic number Z, without the need of a pre-scan setting requiring a special protocol, particularly facilitating emergency situations. Retrospective on-demand spectral analysis could improve the accuracy and diagnostic confidence in cases with ischemia complicating small-bowel obstruction.