Dual-energy computed tomography (DECT) can be used for visualization of pulmonary microvascular contrast material distribution, representing regional perfusion. It is performed as DECT angiography and allows for the reconstruction of morphologic images as well as of "perfusion maps." The authors of previous studies have shown its potential to reliably depict perfusion defects, mainly in the context of pulmonary embolism. Also in the diagnostic work-up of other pulmonary diseases, there might be additional functional information provided by dual-energy acquisition techniques. This review focuses on the physical and technical background and the potential clinical value of pulmonary DECT. Technical improvements of a second-generation dual-source CT system are elucidated.
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