One-stop photon-counting CT angiography for simultaneous assessment of cardio-cerebrovascular lesions: A case report
- 1First Clinical Medical College of Lanzhou University, Lanzhou, 730000, China
- 2Siemens Healthineers (Shanghai) Co., Ltd, Shanghai, China
Abstract
We report a 73-year-old male admitted for 2-year progressive dysuria, with incidental detection of abnormal cardiovascular signs on physical examination. Initial evaluation via energy-integrating detector computed tomography (EID-CT) coronary angiography and cranial magnetic resonance imaging identified key vascular abnormalities, while subsequent photon-counting detector CT (PCD-CT) combined cardio-cerebral computed tomography angiography (CTA) provided more detailed assessment of stenosis severity, plaque composition, and the entire vascular bed. The combined PCD-CT scan delineated synchronous lesions in detail: proximal left anterior descending (LAD) coronary artery plaque, ascending aortic dilatation with left coronary sinus aneurysm compressing the left atrium, and occlusion of the intracranial right vertebral artery. Importantly, PCD-CT cardio-cerebral CTA yielded a lower radiation dose compared with standalone EID-CT coronary angiography. With spectral reconstruction, the severity of LAD stenosis was re-evaluated and interpreted as mild stenosis, a lower grade than that assessed by EID-CT; meanwhile, 0.4 mm thin-slice imaging enabled detailed compositional analysis of the coronary plaque, with imaging features suggestive of a stable plaque. Based on multidisciplinary discussion integrating all imaging findings and clinical context, a treatment strategy was formulated: prioritize high-risk aortic lesion management, synchronously perform coronary artery bypass grafting for myocardial ischemia prevention, and electively address intracranial stenosis. This case demonstrates the preliminary clinical value of PCD-CT as a supportive imaging modality for the evaluation and multidisciplinary management of concurrent cardio-cerebrovascular diseases.
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BibTeX
@article{yuanyuanwan2026onestop,
title = {{One-stop photon-counting CT angiography for simultaneous assessment of cardio-cerebrovascular lesions: A case report}},
author = {Yuanyuan Wan, MBBS and Dandan Zou, MBBS and Jinhui Lan, MMSc and Fan Yang, MD and Jizhao Jiang, MD and Yongwei Liu, MD and Wei Tian, MD and Gang Wang, PhD and Yanli Zhang, MD},
journal = {Radiology Case Reports},
year = {2026},
month = oct,
doi = {10.1016/j.radcr.2026.09.073},
url = {https://doi.org/10.1016/j.radcr.2026.09.073},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - One-stop photon-counting CT angiography for simultaneous assessment of cardio-cerebrovascular lesions: A case report
AU - Yuanyuan Wan, MBBS
AU - Dandan Zou, MBBS
AU - Jinhui Lan, MMSc
AU - Fan Yang, MD
AU - Jizhao Jiang, MD
AU - Yongwei Liu, MD
AU - Wei Tian, MD
AU - Gang Wang, PhD
AU - Yanli Zhang, MD
PY - 2026
DA - 2026/10/22
JO - Radiology Case Reports
DO - 10.1016/j.radcr.2026.09.073
UR - https://doi.org/10.1016/j.radcr.2026.09.073
AB - We report a 73-year-old male admitted for 2-year progressive dysuria, with incidental detection of abnormal cardiovascular signs on physical examination. Initial evaluation via energy-integrating detector computed tomography (EID-CT) coronary angiography and cranial magnetic resonance imaging identified key vascular abnormalities, while subsequent photon-counting detector CT (PCD-CT) combined cardio-cerebral computed tomography angiography (CTA) provided more detailed assessment of stenosis severity, plaque composition, and the entire vascular bed. The combined PCD-CT scan delineated synchronous lesions in detail: proximal left anterior descending (LAD) coronary artery plaque, ascending aortic dilatation with left coronary sinus aneurysm compressing the left atrium, and occlusion of the intracranial right vertebral artery. Importantly, PCD-CT cardio-cerebral CTA yielded a lower radiation dose compared with standalone EID-CT coronary angiography. With spectral reconstruction, the severity of LAD stenosis was re-evaluated and interpreted as mild stenosis, a lower grade than that assessed by EID-CT; meanwhile, 0.4 mm thin-slice imaging enabled detailed compositional analysis of the coronary plaque, with imaging features suggestive of a stable plaque. Based on multidisciplinary discussion integrating all imaging findings and clinical context, a treatment strategy was formulated: prioritize high-risk aortic lesion management, synchronously perform coronary artery bypass grafting for myocardial ischemia prevention, and electively address intracranial stenosis. This case demonstrates the preliminary clinical value of PCD-CT as a supportive imaging modality for the evaluation and multidisciplinary management of concurrent cardio-cerebrovascular diseases.
SN - 1930-0433
ER -