L. Palumbo, Pozzuoli, IT

Abdominal traumatic injuries represent an emergency condition with high mortality, so the prompt evaluation and the correct therapeutic planning are crucial. The CT has become the standard of care for hemodynamically stable patients and the DE- CT could give a great aid, thanks to the variety of post-processing applications.

Imaging findings OR Procedure findings

The identification of parenchymal organs injuries, which appear as hypo-attenuated geographic area, can be challenging in the evaluation of degree and severity of the lesions, particularly in case of not severe damage: DE-CT with low-kilovolt peak and low-kiloelectron volt images improve their visualization. The iodine-selective imaging helps in distinguishing the parenchymal hematomas from organ laceration. Regarding the evaluation of bowel traumatic injuries, iodine-selective and virtual monoenergetic imaging could improve the visibility of altered bowel wall enhancement. Another application of DE-CT could be represented by the study of any vascular injuries: low-kiloelectron volt monoenergetic images and the combined analysis of virtual noncontrast (VNC) and iodine-selective images make ease the identification of active extravasation, also when there are fracture fragments. The VNC images help in the detection of parenchymal, intramural vascular and bowel hematomas.

Conclusion

In the literature, even if there are only few articles about DE-CT application in abdominal trauma and this technique could have pitfalls and artifacts that radiologist must be aware, it seems to be a promising and valuable potential in detecting and better define the injuries.

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