{"paper_id":"398e4bf8-9d68-4bac-99b9-cbebf33d99fd","body_text":"Photon-counting CT angiography in a child with patent ductus arteriosus: a case report | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Photon-counting CT angiography in a child with patent ductus arteriosus: a case report Mingxing Sun This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9096009/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Patent ductus arteriosus (PDA) is a common congenital cardiovascular abnormality characterized by persistent communication between the descending thoracic aorta and the pulmonary artery after birth. Accurate visualization of ductal anatomy is important for diagnosis and treatment planning in children with congenital heart disease. Photon-counting CT (PCCT) is an emerging detector technology that provides improved spatial resolution and reduced electronic noise compared with conventional CT systems. Case We report the case of a 10-year-old girl who underwent CT angiography after a cardiac murmur was detected during routine examination. Photon-counting CT angiography demonstrated abnormal vascular communication between the descending thoracic aorta and the proximal left pulmonary artery, consistent with patent ductus arteriosus. Multiplanar reconstruction clearly depicted the morphology of the ductus arteriosus with a minimal diameter of 3.6-mm and a length of 8.6-mm. Three-dimensional volume-rendered images further illustrated the anatomical relationship between the aorta and the proximal left pulmonary artery. Conclusion Photon-counting CT angiography provides high-resolution visualization of patent ductus arteriosus and may serve as a useful complementary imaging modality for evaluating congenital cardiovascular abnormalities in pediatric patients. Patent ductus arteriosus Congenital heart disease Computed tomography angiography Photon-counting CT Pediatric cardiovascular imaging Computed tomography Figures Figure 1 Figure 2 Figure 3 Figure 4 Introduction Patent ductus arteriosus (PDA) is a common congenital cardiovascular malformation resulting from persistent patency of the fetal ductus arteriosus after birth. It represents abnormal communication between the descending thoracic aorta and the pulmonary artery, potentially leading to significant hemodynamic consequences depending on the size and morphology of the ductus [1,2]. Transthoracic echocardiography is usually the first-line imaging modality for diagnosing PDA in children [3]. However, in some patients the acoustic window may be limited and detailed visualization of ductal morphology may be challenging. Cross-sectional imaging techniques such as CT angiography can provide high spatial resolution and allow accurate assessment of ductal anatomy and adjacent cardiovascular structures [7,8]. Photon-counting CT (PCCT) is a novel CT detector technology that directly converts incoming X-ray photons into electrical signals and measures their energy levels. Compared with conventional energy-integrating detector CT systems, PCCT provides improved spatial resolution and reduced electronic noise, facilitating visualization of small vascular structures in cardiovascular imaging [4–6,9]. We report a pediatric case in which photon-counting CT angiography clearly demonstrated the anatomical characteristics of patent ductus arteriosus. Case A 10-year-old girl was referred for further evaluation after a cardiac murmur was detected during routine physical examination. Physical examination revealed a systolic cardiac murmur without cyanosis or respiratory distress. The patient had no history of previous cardiac intervention. Contrast-enhanced computed tomography angiography (CTA) of the chest was performed using a photon-counting CT system. Iodinated contrast material was administered intravenously prior to scanning. Imaging parameters included a tube voltage of 140 kV and a reconstruction slice thickness of 0.6 mm. Multiplanar reconstruction (MPR) and three-dimensional volume rendering (VR) were subsequently performed for evaluation of vascular anatomy. Imaging findings Axial CT angiography demonstrated abnormal vascular communication between the descending thoracic aorta and the proximal left pulmonary artery, consistent with patent ductus arteriosus (Figure 1). Figure 1 Sagittal multiplanar reconstruction clearly demonstrated the ductus arteriosus extending from the descending thoracic aorta to the proximal left pulmonary artery (Figures 2 and 3). Measurements revealed a minimal ductal diameter of approximately 3.6-mm and a ductal length of approximately 8.6-mm. Figure 2 Figure 3 Three-dimensional volume-rendered images provided a comprehensive view of the spatial relationships among the aortic arch, descending thoracic aorta and proximal left pulmonary artery, clearly depicting the patent ductus arteriosus (Figure 4). Figure 4 Discussion Patent ductus arteriosus is one of the most common congenital heart defects in children and represents persistent patency of the fetal ductus arteriosus after birth [1,2]. Accurate evaluation of the morphology and anatomical relationships of the ductus arteriosus is essential for determining appropriate therapeutic strategies, including transcatheter closure or surgical intervention [10]. Transthoracic echocardiography remains the primary imaging modality for diagnosing patent ductus arteriosus in pediatric patients [3]. Nevertheless, echocardiography may have limitations in certain situations, particularly when acoustic windows are suboptimal or when detailed anatomical visualization is required. CT angiography can provide comprehensive visualization of the ductus arteriosus and adjacent cardiovascular structures with high spatial resolution [7,8]. Photon-counting CT represents a new generation of CT detector technology that offers potential advantages over conventional CT systems. By directly detecting individual photons and measuring their energy levels, PCCT improves spatial resolution and reduces electronic noise [4–6]. These features are particularly beneficial in pediatric cardiovascular imaging, where accurate depiction of small vascular structures is essential [9,11]. In the present case, photon-counting CT angiography clearly demonstrated the ductus arteriosus and enabled precise measurement of ductal diameter and length. Multiplanar reconstruction and three-dimensional volume-rendered imaging further illustrated the spatial relationship between the ductus arteriosus, aortic arch and proximal left pulmonary artery. The improved spatial resolution of photon-counting CT may allow better visualization of small cardiovascular structures while potentially enabling dose-efficient imaging in pediatric patients [12–14]. In selected pediatric patients requiring detailed anatomical assessment, photon-counting CT may therefore serve as a useful complementary imaging technique for evaluating congenital cardiovascular abnormalities. Further studies are needed to clarify its clinical role in pediatric cardiovascular imaging. Conclusion Photon-counting CT angiography provides high-resolution visualization of patent ductus arteriosus and may serve as a valuable complementary imaging modality for detailed evaluation of congenital cardiovascular abnormalities in children. Declarations Written informed consent for participation and publication of this clinical case report, including the accompanying clinical information and images, was obtained from the patient’s legal guardian. References Schneider DJ, Moore JW. Patent ductus arteriosus. Circulation. 2006;114:1873-1882. Mitchell SC, Korones SB, Berendes HW. Congenital heart disease in 56,109 births. Circulation. 1971;43:323-332. Lai WW, et al. Guidelines and standards for performance of a pediatric echocardiogram. J Am Soc Echocardiogr. 2006;19:1413-1430. Willemink MJ, Persson M, Pourmorteza A, et al. Photon-counting CT: technical principles and clinical prospects. Radiology. 2018;289:293-312. Flohr T, Petersilka M. Photon-counting detector CT: system design and clinical applications. Eur Radiol. 2020;30:362-372. Rajendran K, McCollough CH. Photon-counting CT: principles and clinical applications. Radiology. 2022;303:273-285. Goo HW. CT of congenital heart disease in children. Pediatr Radiol. 2010;40:969-980. Goo HW, Park IS. CT angiography in congenital heart disease. Radiographics. 2003;23:S147-S165. Symons R, Cork TE, Sahbaee P, et al. Photon-counting CT for cardiovascular imaging. Radiology. 2020;295:225-236. Porstmann W, et al. Closure of patent ductus arteriosus by catheter technique. Ann Thorac Surg. 1971;11:259-266. McCollough CH, et al. Advances in CT detector technology. Radiology. 2015;276:637-653. Kalender WA. Dose reduction in CT imaging. Eur Radiol. 2014;24:291-298. Frush DP, Donnelly LF. Helical CT in children: technical considerations and body applications. Radiology. 2003;226:309-323. Brady SL, Kaufman RA. Investigation of size-specific dose estimates for pediatric CT. AJR Am J Roentgenol. 2012;199:1121-1126. Goo HW. Imaging congenital heart disease with CT: current status and future directions. Pediatr Radiol. 2019;49:837-849. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-9096009\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":true,\"archivedVersions\":[],\"articleType\":\"Case Report\",\"associatedPublications\":[],\"authors\":[{\"id\":604841938,\"identity\":\"43e577b5-d9b5-41f5-b280-1169da36ff26\",\"order_by\":0,\"name\":\"Mingxing 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15:10:20\",\"currentVersionCode\":1,\"declarations\":\"\",\"doi\":\"10.21203/rs.3.rs-9096009/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-9096009/v1\",\"draftVersion\":[],\"editorialEvents\":[],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":104998695,\"identity\":\"573ad87e-bb54-4618-8a02-7d67decdf44e\",\"added_by\":\"auto\",\"created_at\":\"2026-03-19 16:31:04\",\"extension\":\"png\",\"order_by\":1,\"title\":\"Figure 1\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":221850,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eAxial CT angiography demonstrating abnormal communication between the descending thoracic aorta and the proximal left pulmonary artery (arrow), consistent with patent ductus 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3\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":319945,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eSagittal reconstructed image illustrating the ductus arteriosus (arrow) and its anatomical relationship with the aortic arch, with a ductal length of approximately 8.6-mm.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"3.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-9096009/v1/924aa1e08cca1fda86c6423a.png\"},{\"id\":105035289,\"identity\":\"a66a1b21-020c-4115-9e9f-36727dc44e95\",\"added_by\":\"auto\",\"created_at\":\"2026-03-20 07:25:48\",\"extension\":\"png\",\"order_by\":4,\"title\":\"Figure 4\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":522894,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eThree-dimensional volume-rendered image demonstrating the spatial relationship among the aortic arch, descending thoracic aorta and proximal left pulmonary artery, clearly depicting the patent ductus arteriosus (arrow).\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"4.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-9096009/v1/e832cd76ecb47fcb4737ef84.png\"},{\"id\":105036719,\"identity\":\"40e7dd17-f310-49e1-81ea-1033416fc553\",\"added_by\":\"auto\",\"created_at\":\"2026-03-20 07:35:39\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":2281157,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-9096009/v1/b7080545-0f6e-4d19-9765-659ff850a91a.pdf\"}],\"financialInterests\":\"No competing interests reported.\",\"formattedTitle\":\"Photon-counting CT angiography in a child with patent ductus arteriosus: a case report\",\"fulltext\":[{\"header\":\"Introduction\",\"content\":\"\\u003cp\\u003ePatent ductus arteriosus (PDA) is a common congenital cardiovascular malformation resulting from persistent patency of the fetal ductus arteriosus after birth. It represents abnormal communication between the descending thoracic aorta and the pulmonary artery, potentially leading to significant hemodynamic consequences depending on the size and morphology of the ductus [1,2].\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eTransthoracic echocardiography is usually the first-line imaging modality for diagnosing PDA in children [3]. However, in some patients the acoustic window may be limited and detailed visualization of ductal morphology may be challenging. Cross-sectional imaging techniques such as CT angiography can provide high spatial resolution and allow accurate assessment of ductal anatomy and adjacent cardiovascular structures [7,8].\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003ePhoton-counting CT (PCCT) is a novel CT detector technology that directly converts incoming X-ray photons into electrical signals and measures their energy levels. Compared with conventional energy-integrating detector CT systems, PCCT provides improved spatial resolution and reduced electronic noise, facilitating visualization of small vascular structures in cardiovascular imaging [4\\u0026ndash;6,9].\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eWe report a pediatric case in which photon-counting CT angiography clearly demonstrated the anatomical characteristics of patent ductus arteriosus.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\"},{\"header\":\"Case\",\"content\":\"\\u003cp\\u003eA 10-year-old girl was referred for further evaluation after a cardiac murmur was detected during routine physical examination. Physical examination revealed a systolic cardiac murmur without cyanosis or respiratory distress. The patient had no history of previous cardiac intervention.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eContrast-enhanced computed tomography angiography (CTA) of the chest was performed using a photon-counting CT system. Iodinated contrast material was administered intravenously prior to scanning. Imaging parameters included a tube voltage of 140 kV and a reconstruction slice thickness of 0.6 mm. Multiplanar reconstruction (MPR) and three-dimensional volume rendering (VR) were subsequently performed for evaluation of vascular anatomy.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eImaging findings\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eAxial CT angiography demonstrated abnormal vascular communication between the descending thoracic aorta and the proximal left pulmonary artery, consistent with patent ductus arteriosus (Figure 1).\\u003c/p\\u003e\\n\\u003cp\\u003eFigure 1\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eSagittal multiplanar reconstruction clearly demonstrated the ductus arteriosus extending from the descending thoracic aorta to the proximal left pulmonary artery (Figures 2 and 3). Measurements revealed a minimal ductal diameter of approximately 3.6-mm and a ductal length of approximately 8.6-mm.\\u003c/p\\u003e\\n\\u003cp\\u003eFigure 2\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eFigure 3 \\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003eThree-dimensional volume-rendered images provided a comprehensive view of the spatial relationships among the aortic arch, descending thoracic aorta and proximal left pulmonary artery, clearly depicting the patent ductus arteriosus (Figure 4).\\u003c/p\\u003e\\n\\u003cp\\u003eFigure 4\\u0026nbsp;\\u003c/p\\u003e\"},{\"header\":\"Discussion\",\"content\":\"\\u003cp\\u003ePatent ductus arteriosus is one of the most common congenital heart defects in children and represents persistent patency of the fetal ductus arteriosus after birth [1,2]. Accurate evaluation of the morphology and anatomical relationships of the ductus arteriosus is essential for determining appropriate therapeutic strategies, including transcatheter closure or surgical intervention [10].\\u003c/p\\u003e\\n\\u003cp\\u003eTransthoracic echocardiography remains the primary imaging modality for diagnosing patent ductus arteriosus in pediatric patients [3]. Nevertheless, echocardiography may have limitations in certain situations, particularly when acoustic windows are suboptimal or when detailed anatomical visualization is required. CT angiography can provide comprehensive visualization of the ductus arteriosus and adjacent cardiovascular structures with high spatial resolution [7,8].\\u003c/p\\u003e\\n\\u003cp\\u003ePhoton-counting CT represents a new generation of CT detector technology that offers potential advantages over conventional CT systems. By directly detecting individual photons and measuring their energy levels, PCCT improves spatial resolution and reduces electronic noise [4\\u0026ndash;6]. These features are particularly beneficial in pediatric cardiovascular imaging, where accurate depiction of small vascular structures is essential [9,11].\\u003c/p\\u003e\\n\\u003cp\\u003eIn the present case, photon-counting CT angiography clearly demonstrated the ductus arteriosus and enabled precise measurement of ductal diameter and length. Multiplanar reconstruction and three-dimensional volume-rendered imaging further illustrated the spatial relationship between the ductus arteriosus, aortic arch and proximal left pulmonary artery.\\u003c/p\\u003e\\n\\u003cp\\u003eThe improved spatial resolution of photon-counting CT may allow better visualization of small cardiovascular structures while potentially enabling dose-efficient imaging in pediatric patients [12\\u0026ndash;14]. In selected pediatric patients requiring detailed anatomical assessment, photon-counting CT may therefore serve as a useful complementary imaging technique for evaluating congenital cardiovascular abnormalities. Further studies are needed to clarify its clinical role in pediatric cardiovascular imaging.\\u003c/p\\u003e\"},{\"header\":\"Conclusion\",\"content\":\"\\u003cp\\u003ePhoton-counting CT angiography provides high-resolution visualization of patent ductus arteriosus and may serve as a valuable complementary imaging modality for detailed evaluation of congenital cardiovascular abnormalities in children.\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003e\\u003cspan\\u003eWritten informed consent for participation and publication of this clinical case report, including the accompanying clinical information and images, was obtained from the patient\\u0026rsquo;s legal guardian.\\u003c/span\\u003e\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\n\\u003cli\\u003eSchneider DJ, Moore JW. Patent ductus arteriosus. Circulation. 2006;114:1873-1882.\\u003c/li\\u003e\\n\\u003cli\\u003eMitchell SC, Korones SB, Berendes HW. Congenital heart disease in 56,109 births. Circulation. 1971;43:323-332.\\u003c/li\\u003e\\n\\u003cli\\u003eLai WW, et al. Guidelines and standards for performance of a pediatric echocardiogram. J Am Soc Echocardiogr. 2006;19:1413-1430.\\u003c/li\\u003e\\n\\u003cli\\u003eWillemink MJ, Persson M, Pourmorteza A, et al. Photon-counting CT: technical principles and clinical prospects. Radiology. 2018;289:293-312.\\u003c/li\\u003e\\n\\u003cli\\u003eFlohr T, Petersilka M. Photon-counting detector CT: system design and clinical applications. Eur Radiol. 2020;30:362-372.\\u003c/li\\u003e\\n\\u003cli\\u003eRajendran K, McCollough CH. Photon-counting CT: principles and clinical applications. Radiology. 2022;303:273-285.\\u003c/li\\u003e\\n\\u003cli\\u003eGoo HW. CT of congenital heart disease in children. Pediatr Radiol. 2010;40:969-980.\\u003c/li\\u003e\\n\\u003cli\\u003eGoo HW, Park IS. CT angiography in congenital heart disease. Radiographics. 2003;23:S147-S165.\\u003c/li\\u003e\\n\\u003cli\\u003eSymons R, Cork TE, Sahbaee P, et al. Photon-counting CT for cardiovascular imaging. Radiology. 2020;295:225-236.\\u003c/li\\u003e\\n\\u003cli\\u003ePorstmann W, et al. Closure of patent ductus arteriosus by catheter technique. Ann Thorac Surg. 1971;11:259-266.\\u003c/li\\u003e\\n\\u003cli\\u003eMcCollough CH, et al. Advances in CT detector technology. Radiology. 2015;276:637-653.\\u003c/li\\u003e\\n\\u003cli\\u003eKalender WA. Dose reduction in CT imaging. Eur Radiol. 2014;24:291-298.\\u003c/li\\u003e\\n\\u003cli\\u003eFrush DP, Donnelly LF. Helical CT in children: technical considerations and body applications. Radiology. 2003;226:309-323.\\u003c/li\\u003e\\n\\u003cli\\u003eBrady SL, Kaufman RA. Investigation of size-specific dose estimates for pediatric CT. AJR Am J Roentgenol. 2012;199:1121-1126.\\u003c/li\\u003e\\n\\u003cli\\u003eGoo HW. Imaging congenital heart disease with CT: current status and future directions. Pediatr Radiol. 2019;49:837-849.\\u003c/li\\u003e\\n\\u003c/ol\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":true,\"hideJournal\":true,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true},\"keywords\":\"Patent ductus arteriosus, Congenital heart disease, Computed tomography angiography, Photon-counting CT, Pediatric cardiovascular imaging, Computed tomography\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-9096009/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-9096009/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003cp\\u003e\\u003cstrong\\u003eBackground\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003ePatent ductus arteriosus (PDA) is a common congenital cardiovascular abnormality characterized by persistent communication between the descending thoracic aorta and the pulmonary artery after birth. Accurate visualization of ductal anatomy is important for diagnosis and treatment planning in children with congenital heart disease. Photon-counting CT (PCCT) is an emerging detector technology that provides improved spatial resolution and reduced electronic noise compared with conventional CT systems.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eCase\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eWe report the case of a 10-year-old girl who underwent CT angiography after a cardiac murmur was detected during routine examination. Photon-counting CT angiography demonstrated abnormal vascular communication between the descending thoracic aorta and the proximal left pulmonary artery, consistent with patent ductus arteriosus. Multiplanar reconstruction clearly depicted the morphology of the ductus arteriosus with a minimal diameter of 3.6-mm and a length of 8.6-mm. Three-dimensional volume-rendered images further illustrated the anatomical relationship between the aorta and the proximal left pulmonary artery.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConclusion\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003ePhoton-counting CT angiography provides high-resolution visualization of patent ductus arteriosus and may serve as a useful complementary imaging modality for evaluating congenital cardiovascular abnormalities in pediatric patients.\\u003c/p\\u003e\",\"manuscriptTitle\":\"Photon-counting CT angiography in a child with patent ductus arteriosus: a case report\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2026-03-19 16:31:00\",\"doi\":\"10.21203/rs.3.rs-9096009/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"60346cce-c8ed-4fb8-87ba-1ed59d845e39\",\"owner\":[],\"postedDate\":\"March 19th, 2026\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"posted\",\"subjectAreas\":[],\"tags\":[],\"updatedAt\":\"2026-03-19T16:31:00+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2026-03-19 16:31:00\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-9096009\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-9096009\",\"identity\":\"rs-9096009\",\"version\":[\"v1\"]},\"buildId\":\"XKTyCvWXoU3ODBz1xrDgd\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}