Purpose or Case Report: Dual energy CT with material-specific reconstructions including iodine, pulmonary blood volume, and lung vessel images can improve assessment of vascular and associated parenchymal abnormalities.
An understanding of material-specific reconstruction algorithms, clinical applications and potential pitfalls can help in accurate interpretation of dual energy CT examinations.

Purpose of this exhibit is to review:

Basic principles of dual energy CT material-specific reconstructions
● Iodine maps
● Pulmonary blood volume (PBV) images
● Lung vessel images

Specific applications and benefits of material-specific reconstructions in cardiothoracic imaging
● Pulmonary embolism: Vessel and PBV images can improve detection of embolus and infarction
● Congenital cyanotic heart disease: Material-specific reconstructions can have a role in assessing pulmonary artery flow/lung perfusion and adequacy of reconstruction surgery
● Arteriovenous malformations: Material-specific images can increase conspicuity of small malformations and can be used to evaluate the success of embolization
● Pulmonary hypertension: Material-specific images are useful to detect subtle decreases in parenchymal perfusion and pulmonary blood flow
● Airway diseases: Reconstructions can provide information on the downhill effect of bronchial obstruction.

Potential pitfalls and artifacts in interpreting material specific reconstructions
● Beam-hardening artifacts
● Diaphragmatic motion
● Cardiac motion

Radiation Dose: Similar or less than single-energy CT
Methods & Materials:
Results:
Conclusions: Dual-energy CT with material-specific reconstructions can lead to diagnostic benefits in management of cardiothoracic diseases in pediatric clinical practice and increase diagnostic confidence.