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

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.