Giant-cell arteritis on photon-counting detector CT: A case report

Area of Science:

• Vascular Imaging
• Rheumatology
• Medical Diagnostics

Background:

• Giant cell arteritis (GCA) is a systemic vasculitis affecting large and medium-sized arteries, primarily the aorta and its branches.
• Early diagnosis and treatment are crucial to prevent complications such as vision loss and stroke.

Observation:

• A 77-year-old woman presented with symptoms suggestive of GCA, including fever, headache, and temporal artery abnormalities.
• Color Doppler ultrasonography revealed hypoechoic mural thickening in the superficial temporal arteries (STAs).
• Contrast-enhanced photon-counting detector (PCD) CT demonstrated mural thickening and stenosis in the bilateral STAs.

Findings:

• Histopathological examination of the STA biopsy confirmed GCA.
• While initial steroid treatment provided temporary relief, the patient later developed jaw claudication.
• Follow-up contrast-enhanced CT revealed improved STA abnormalities but new stenosis in the maxillary arteries.

Implications:

• PCD-CT imaging offers superior resolution, contrast, and lower noise compared to conventional CT.
• PCD-CT shows significant potential for the accurate detection, diagnosis, and ongoing monitoring of GCA.
• This advanced imaging modality may improve patient management and outcomes in GCA.