Virtual monochromatic versus conventional polychromatic CT images in patients with acute bowel ischaemia

Question Can we rely on virtual monochromatic CT images to detect reduced or absent bowel wall enhancement in acute bowel ischaemia? Findings Virtual monochromatic CT images have equal diagnostic value for detecting acute bowel ischaemia as conventionally acquired polychromatic CT images without significant qualitative or quantitative differences. Clinical relevance Significant differences in bowel wall density between healthy and pathological segments on subtraction virtual monochromatic images allow us to rely on the virtual non-enhanced phase instead of acquiring an additional non-enhanced phase in acute bowel ischaemia, leading to dose reduction.