Objective To investigate the feasibility of second-generation dual-source computed tomography（DSCT）with low-tube-voltage

high-pitch

and sinogram-affirmed iterative reconstruction（SAFIRE）in the examination of emergency traumatic fractures. Methods A prospective study was conducted in 23 patients who were admitted to our hospital and required CT examination due to emergency trauma. Each patient was examined with CT using both the following A and B protocols: Standard scanning protocol（first examination

A）/low-dose scanning protocol（re-examination

B）

tube voltage 120 kv/100 kv（for the spine

ribs

pelvis

and hip joint）

100 kv/80 kv（for the limbs）

pitch 1.0/3.0

and filtered back projection/SAFIRE. The A and B protocols were compared in terms of radiation dose（volume CT dose index [CTDIvol]

dose-length product [DLP]）

scanning time

image quality

and diagnostic efficacy. Results Compared with the A protocol

the B protocol had significantly reduced CTDIvol（2.86 ± 1.61 mGy vs 8.87 ± 4.47 mGy

t =-4.198

P < 0.001）

DLP（110.09 ± 87.19 m Gy·cm vs 301.65 ±236.04 mGy · cm

t = 6.022

P < 0.001）

and scanning time（0.90 ± 0.43 s vs 5.90 ± 3.00 s

t = 8.880

P <0.001）

and the reduction was 67.8%

63.5%

and 84.75%

respectively. Both A and B protocols had an image quality score of no less than 4 points

both meeting the diagnostic requirement

with no significant difference（t =-1.582

P > 0.05）. Both A and B protocols detected all fractures. The two doctors had a high consistency in the image quality scoring（K = 0.664）. Conclusion The application of second-generation DSCT with low-tube-voltage

high-pitch

and SAFIRE in the examination of emergency traumatic fractures can significantly reduce the radiation dose and scanning time

with good image quality which satisfies the clinical diagnosis. When the traumatic patients are re-examined to obtain the status of fracture

a low-dose CT scanning protocol can be used to reduce the radiation dose.