Spontaneous renal artery dissection
47 yo M presents with sudden onset LUQ pain.
Conventional CT shows focal cortical hypo-density in left kidney. Note complete absence of iodine uptake on spectral analysis, consistent with infarct.
Careful evaluation of left renal artery on 40 keV images shows a distinct flap consistent with dissection. No central source of clot was discovered, and patient was managed conservatively.
This is a pretty rare entity, not previously described with spectral CT.