To see if there are features on dual energy CT that can aid in the detection of vertebral artery dissection.

Background Vertebral artery dissection is a difficult diagnosis that can be a dilemma for neurologists and radiologists. MRI is seen as the gold standard for diagnosis. However, MRI may not always be possible or available in a timely fashion. CT technology has advanced in recent years with dual energy CT Methods/Study Design Between September 2020 and May 2021, 4 patients presented to a mid-size hospital with neurological symptoms concerning for stroke and TIA. These patients had an initial CT angiogram of their neck and head....

3 out of the 4 patients had both thickening of the vessel wall on curved MPR reconstructions and markedly reduced attenuation(>250HU) of the affected vertebral artery vs the unaffected side at the level of the occipital condyle on the 45keV mono energy reconstruction. 1 of the 4 patients had sections of occlusion/loss of contrast opacification along the affected vertebral artery that precluded vessel tracking to allow a curved MPR reconstruction but also demonstrated marked attenuation on the 45keV mono energy reconstruction at the level of...

There were features on the dual energy CT angiogram, which included reduce attenuation on the affected side on the low energy mono energy reconstruction and vessel wall thickening on curved MPR reconstruction which could help in diagnosing vertebral artery dissection Discussion: Vertebral artery dissection can often be quite difficult to detect and manage, CT findings can be subtle, especially in cases of normal variants (hypoplastic side) that can mimic dissection. Often MRI is needed to make the diagnosis, but the use of MRI is not...

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