Published online Sep 14, 2015. doi: 10.3748/wjg.v21.i34.9993
Peer-review started: March 27, 2015
First decision: May 18, 2015
Revised: June 2, 2015
Accepted: June 26, 2015
Article in press: June 26, 2015
Published online: September 14, 2015
Core tip: In traditional computed tomography (CT), gallbladder stones are indicated directly by high-density or low-density stones and indirectly by dilation of the intrahepatic biliary duct, left and right hepatic ducts, biliary duct and gallbladder. However, it is difficult to diagnose iso-density gallbladder stones, because gallbladder stones and bile are difficultly distinguished by traditional CT due to a same density. The development of spectral imaging recoups the defects of traditional CT in the diagnosis of iso-density stones. In spectral imaging, base substance images and low keV images are both promising to improve the detection rate of gallbladder stones; they provide a new approach for the differential diagnosis of gallbladder stones, and the reliable information for the clinical treatment of gallbladder stones.