Dual-Energy CT: A Paradigm Shift in Acute Traumatic Abdomen

Abstract

<jats:p> Abdominal trauma, one of the leading causes of death under the age of 45, can be broadly classified into blunt and penetrating trauma, based on the mechanism of injury. Blunt abdominal trauma usually results from motor vehicle collisions, fall from heights, assaults, and sports and is more common than penetrating abdominal trauma, which is usually seen in firearm injuries and stab wounds. In both blunt and penetrating abdominal trauma, an optimized imaging approach is mandatory to exclude life-threatening injuries. Easy availability of the portable ultrasound in the emergency department and trauma bay makes it one of the most commonly used screening imaging modalities in the abdominal trauma, especially to exclude hemoperitoneum. Evaluation of the visceral and vascular injuries in a hemodynamically stable patient, however, warrants intravenous contrast-enhanced multidetector computed tomography scan. Dual-energy computed tomography with its postprocessing applications such as iodine selective imaging and virtual monoenergetic imaging can reliably depict the conspicuity of traumatic solid and hollow visceral and vascular injuries. </jats:p>

CARJ 2021: Year in Review

“…Other articles this year have also illustrated the versatility of DECT in trauma and neuroradiology imaging due to postprocessing techniques that capitalize on the k-edge of iodine. 8,9 DECT allows the identification of small bleeds and assessment of organ perfusion, differentiation of hemorrhage and luxury perfusion in post stroke imaging, and artifact reduction. 8,9 An emerging area of imaging which is not yet widely used is ultra-high frequency ultrasound (UHFUS).…”

“…8,9 DECT allows the identification of small bleeds and assessment of organ perfusion, differentiation of hemorrhage and luxury perfusion in post stroke imaging, and artifact reduction. 8,9 An emerging area of imaging which is not yet widely used is ultra-high frequency ultrasound (UHFUS). A review of UHFUS usage and statistical efficacy was published this year in the CARJ.…”

“…8,9 DECT allows the identification of small bleeds and assessment of organ perfusion, differentiation of hemorrhage and luxury perfusion in post stroke imaging, and artifact reduction. 8,9…”

An Overview on Splenic Trauma Management Approach

“…A Helical or spiral CT scan is preferred to exploratory laparotomy as it is overall accurate and non-invasive. [9] In addition to diagnosis, the CT imaging would also aid in staging the splenic injury, and suitable candidates could be prepared for surgery. Another important factor that would relatively contraindicate a non-operative approach is the presence of co-morbid conditions.…”

Solid Organs Injuries in Blunt Abdominal Trauma Patients

“…The liver and spleen are the most commonly injured organs after blunt abdominal trauma likely due to their close proximity to the abdominal wall. Injuries to the pancreas, kidney, and bladder are less common and less easy to diagnose (5) . Due to high rate of operative mortality and morbidity non-operative management of blunt liver and spleen trauma was widely accepted in stable pediatric patients, but the general surgeons were skeptical to adopt it for adults.…”