From the Department of Radiology, Division of Emergency Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115.
Radiographics. 2018 Mar-Apr;38(2):586-602. doi: 10.1148/rg.2018170058.
Computed tomography (CT) is key to the assessment of hemodynamically stable patients with blunt or penetrating trauma to the abdomen and pelvis. Dual-energy (DE) CT is a technology that allows acquisition of data at both high and low kilovolt peaks, allowing materials that have different x-ray absorption behaviors as a function of kilovolt peak (such as iodine) to be differentiated and quantified. DE CT has a variety of postprocessing applications that may be helpful in abdominal and pelvic trauma, including iodine-selective imaging, virtual monenergetic imaging, and virtual noncalcium imaging. Both iodine-selective imaging and virtual monoenergetic imaging can increase the conspicuity of traumatic solid-organ and hollow visceral injuries, making injuries easier to detect and categorize. Iodine-selective imaging, through the use of iodine maps and virtual noncontrast images, can assist in the evaluation of active contrast extravasation. Virtual noncalcium images can unmask bone marrow edema, improving detection of subtle fractures. The purpose of this review article is to familiarize radiologists with the basic physics and technical principles of DE CT, common postprocessing techniques, and the potential added value of DE CT in patients with abdominal and pelvic trauma. The technical limitations of DE CT are also reviewed, as are diagnostic pitfalls and common challenges in interpretation. RSNA, 2018.
计算机断层扫描（CT）是评估腹部和骨盆钝性或穿透性创伤患者血流动力学稳定的关键。双能（DE）CT 是一种允许在高千伏和低千伏峰值采集数据的技术，允许对具有不同 X 射线吸收行为的物质（如碘）进行区分和定量。DE CT 具有多种后处理应用，可能有助于腹部和骨盆创伤，包括碘选择性成像、虚拟单能量成像和虚拟非钙成像。碘选择性成像和虚拟单能量成像都可以提高创伤性实质性和中空内脏损伤的显影，使损伤更容易发现和分类。碘选择性成像通过使用碘图和虚拟非对比图像，有助于评估活性对比外渗。虚拟非钙图像可以揭示骨髓水肿，提高对细微骨折的检测能力。本文旨在使放射科医生熟悉 DE CT 的基本物理和技术原理、常见的后处理技术以及 DE CT 在腹部和骨盆创伤患者中的潜在附加价值。还回顾了 DE CT 的技术局限性，以及诊断陷阱和常见的解释挑战。RSNA，2018.
