Learning objectives
Dual-energy computed tomography (DECT) has become one of the most promising and attractive fields in modern radiology. The aim of this review is to raise awareness about the role and multiple applications of DECT in the emergency room. Also, the objective is to review its main indications as well as radiological findings of frequent pathologies and to collect the main advantages and disadvantages.
Background
PHYSICAL PRINCIPLES OF DUAL ENERGY
Single or conventional CT uses a single polychromatic X-ray beam, usually ranging from 70 kV to 140 kV, emitted from a single source.
Dual-energy refers to the use of two different X-ray spectra in computerized tomography (typically 80kV and 140 kV) to acquire images that can be processed to generate additional data.
The basic principle of DECT consists of the idea that the degree of attenuation of a particular tissue (reflected by Hounsfield Units, HU) depends on its composition (density...
Findings and procedure details
MAIN APPLICATIONS IN EMERGENCY RADIOLOGY
Stroke and intracranial hemorrhage
In stroke patients, distinguish intracranial hemorrhage from contrast media staining early after recanalization treatment could be very complicated as they both appear as a hyperdensity area within the affected parenchyma. This distinction is of great importance when the decision to continue or initiate antiplatelet or anticoagulation therapy is being considered. DECT allows quantifying blood and iodine in VCN and iodine maps to differentiate the hyperdensities lesions on conventional CT [3].[Fig 4][Fig 5][Fig 6]
In non-traumatic intracranial...
Conclusion
The continuous technological advancement constitutes one of the fundamental pillars in radiology, however, the use of increasingly complex techniques, such as dual-energy, carries new challenges. Despite having proven its unquestionable benefits in emergency radiology, more research is needed to discover its full potential.
Personal information and conflict of interest
M. Da Silva Torres:
Nothing to disclose
H. Cigarrán Sexto:
Nothing to disclose
J. Calvo Blanco:
Nothing to disclose
A. Barrio Alonso:
Nothing to disclose
M. Martínez-Cachero García:
Nothing to disclose
L. M. Guadalupe González:
Nothing to disclose
S. A. Jarreta:
Nothing to disclose
P. Corujo Murga:
Nothing to disclose
F. García Arias:
Nothing to disclose
References
Grajo JR, Patino M, Prochowski A, Sahani DV. Dual-energy CT in practice: Basic principles and applications. Appl Radiol. 2016;45:6–12.
Aran S, Daiari Besheli L, Karcaalncaba M, Gupta R, Flores EJ, Abujudeh HH. Applications of dual-energy CT in emergency radiology. AJR Am J Roentgenol 2014;202:W314-24.
Gupta R, Phan CM, Leidecker C, et al. Evaluation of dual-energy CT for differentiating intracerebral hemorrhage from iodinated contrast material staining. Radiology 2010;257(1):205–211.
Kim SJ, Lim HK, Lee HY, et al. Dual-energy CT in the evaluation of intracerebral hemorrhage of unknown...