Added Value of Dual-energy CT in Musculoskeletal Trauma

Presentation Format: Educational poster presentation.

Purpose or Learning Objective: This work aims to (1) describe the basic principles of dual-energy CT (DECT); (2) review and illustrate the applications of DECT in musculoskeletal trauma; and (3) discuss the advantages and limitations of this technique.

Methods or Background: DECT is increasingly being used in clinical practice, and its applications have been widening in the field of musculoskeletal radiology. Its use is particularly suited to trauma imaging, in which CT is often the technique of choice due to its availability and rapid acquisition of volumetric images. Dual energy increases the capacity to detect and further characterize bone and soft tissue lesions in the setting of acute trauma.

Results or Findings: The use of a virtual non-calcium subtraction technique allows the detection of bone marrow edema in cases of contusion. We illustrate cases highlighting the use of DECT in spine trauma, distinguishing between acute and chronic compression fractures. In patients with traumatic sequelae, this technique allows the identification of new lesions. Detection of bone marrow edema also enhances sensitivity and diagnostic confidence in identifying subtle fractures as well as distinguishing bone avulsions from normal variants.

Through collagen analysis, we could identify tears of tendons and ligaments.

Metal artifact reduction allows the diagnosis of complications of a bone prothesis.

Conclusion: DECT has enormous potential in the context of musculoskeletal trauma. Through bone marrow detection, collagen analysis, and metal artifact reduction, radiologists may diagnose lesions previously undetected with conventional CT and thus influence patient management.

Publication History

Article published online:
03 June 2021