Application of dual-energy computed tomography in neuroradiology — a review of literature

Imaging diagnostics, supported by advances in medical equipment and software, is a dynamically evolving field of medicine. Methods that improve the precision of disease detection are currently in high demand. This paper discusses spectral computed tomography (CT), specifically dual-energy computed tomography (DECT), which is a modern and advanced imaging technique offering significant advantages over conventional single-energy CT (SECT). DECT provides additional diagnostic information and reduces the effective dose of ionizing radiation to the patient. A key benefit of DECT is its ability to reduce image artifacts compared to SECT. The article explains the operating principles of DECT and reviews its clinical indications, with a focus on neuroradiology. Special attention is given to the differentiation of intracranial hemorrhage from calcifications and distinguishing fresh blood from iodinated contrast media - especially in overlapping areas - through the interpretation of base pair images. DECT also plays an important role in evaluating the progression of intracerebral hematomas and detecting the "spot sign" in CT angiography (CTA) of the brain. Another application is in imaging the vascular system of the head and neck using DECTA, where bone removal and virtual non-contrast image reconstruction are particularly useful. The final section of the paper addresses artifact reduction methods in neuroradiology and outlines the key advantages and limitations of DECT in clinical practice.