Spectral CT
Truth in beauty and beauty in layers...

Cases

Stab wound with active extravasation

50 yo F stabbed with a butchers knife. Multiple stab wounds. Routine CT shows subtle extravasation of contrast inferior to the scapula. 

This is much more obvious on the 40 keV image. Note absence of density on virtual non-contrast confirms this is a iodine extravasation and not a foreign body or bone fragment.

I have found 40 keV images to be very helpful to confirm contrast extravasation in trauma.

Conventional CT with subtle hyperdensity inferior to the right scapula in the back

Conventional CT with subtle hyperdensity inferior to the right scapula in the back

40 keV image makes finding very easy to appreciate (yellow arrow)

40 keV image makes finding very easy to appreciate (yellow arrow)

Absence of density on virtual non-contrast confirms contrast extravasation

Absence of density on virtual non-contrast confirms contrast extravasation

Gopal PunjabiComment