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Photon-counting detector CT vs energy-integrating detector CT for the diagnosis of arterial dissection in the cervicocerebral region: A single-center case series

K. Matsumoto, Masahiro Nakashima, Tatsuya Kawai, T. Kawaguchi, M. Urano, N. Kitera, Seita Watanabe, A. Hiwatashi

Radiology Case Reports, 2026

11 participants

Abstract

This study compared the imaging findings and diagnostic confidence of photon-counting detector CT (PCD-CT) and energy-integrating detector CT (EID-CT) for identifying cervicocerebral arterial dissections. We retrospectively analyzed 22 cases (11 PCD-CT and 11 EID-CT). Imaging findings, diagnostic confidence, and radiation exposure were assessed, and all patients underwent MRI or digital subtraction angiography for confirmation. Dissection was identified in 9/11 patients (82%) using PCD-CT and in 4/11 patients (36%) using EID-CT. Two PCD-CT cases and 7 EID-CT cases required MRI or DSA because neither an intimal flap nor a contrast-enhanced false lumen could be identified on CTA. Delayed-phase imaging improved visualization in 2 PCD-CT cases. There were no significant differences in CT dose index volume (CTDIvol) or dose-length product (DLP) between the 2 groups. Under the imaging conditions used in this study, PCD-CT provided clearer visualization of cervicocerebral arterial dissection than EID-CT at a comparable radiation dose, particularly when delayed-phase imaging was combined with PCD-CT's high contrast resolution.

How strong is the evidence?

Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 11 participants or records.

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