Dual-energy CT of acute bowel ischemia.

Autor: Obmann MM; Clinic of Radiology and Nuclear Imaging, University Hospital Basel, Petersgraben 4, 4051, Basel, Switzerland. markusobmann@gmail.com.; Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA. markusobmann@gmail.com., Punjabi G; Hennepin Healthcare, Department of Radiology, Minneapolis, USA., Obmann VC; Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Boll DT; Clinic of Radiology and Nuclear Imaging, University Hospital Basel, Petersgraben 4, 4051, Basel, Switzerland., Heye T; Clinic of Radiology and Nuclear Imaging, University Hospital Basel, Petersgraben 4, 4051, Basel, Switzerland., Benz MR; Clinic of Radiology and Nuclear Imaging, University Hospital Basel, Petersgraben 4, 4051, Basel, Switzerland.; Department of Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, USA., Yeh BM; Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA.
Jazyk: angličtina
Zdroj: Abdominal radiology (New York) [Abdom Radiol (NY)] 2022 May; Vol. 47 (5), pp. 1660-1683. Date of Electronic Publication: 2021 Jun 30.
DOI: 10.1007/s00261-021-03188-4
Abstrakt: Acute bowel ischemia is a condition with high mortality and requires rapid intervention to avoid catastrophic outcomes. Swift and accurate imaging diagnosis is essential because clinical findings are commonly nonspecific. Conventional contrast enhanced CT of the abdomen has been the imaging modality of choice to evaluate suspected acute bowel ischemia. However, subtlety of image findings and lack of non-contrast or arterial phase images can make correct diagnosis challenging. Dual-energy CT provides valuable information toward assessing bowel ischemia. Dual-energy CT exploits the differential X-ray attenuation at two different photon energy levels to characterize the composition of tissues and reveal the presence or absence of faint intravenous iodinated contrast to improve reader confidence in detecting subtle bowel wall enhancement. With the same underlying technique, virtual non-contrast images can help to show non-enhancing hyperdense hemorrhage of the bowel wall in intravenous contrast-enhanced scans without the need to acquire actual non-contrast scans. Dual-energy CT derived low photon energy (keV) virtual monoenergetic images emphasize iodine contrast and provide CT angiography-like images from portal venous phase scans to better evaluate abdominal arterial patency. In Summary, dual-energy CT aids diagnosing acute bowel ischemia in multiple ways, including improving visualization of the bowel wall and mesenteric vasculature, revealing intramural hemorrhage in contrast enhanced scans, or possibly reducing intravenous contrast dose.
(© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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