DECT Perfusion Map Has Ability to Depict Microthrombi as Perfusion Defects

Background: Sickle cell disease (SCD) is the most common inherited blood disorder in the United States and affects the structure of hemoglobin, resulting in the formation of rigid crescent-shaped red blood cells. Acute chest syndrome (ACS) is a severe and life-threatening complication, which presents as an acute respiratory condition characterized by chest pain, cough, dyspnea, and pulmonary opacities thought to be due to occlusion of the pulmonary microvasculature. Pulmonary thromboembolism (PE) without deep vein thrombosis (DVT), occurs in approximately 20% of ACS on CT pulmonary angiography (CTPA). The remaining 80% of ACS patients are thought to have subclinical (by CT) microvascular insults. Additional challenges to the diagnosis of PE in SCD is that D -dimer levels are elevated even in a steady state. Dual-energy CT (DECT) may be helpful in this diagnosis as it can show enhanced tissue characterization, improved visual contrast, and volumetric fraction iodine quantification due more...