• Clinical radiology · Jan 2013

    Comparative Study

    320-detector row CT angiography for detection and evaluation of intracranial aneurysms: comparison with conventional digital subtraction angiography.

    • H Wang, W Li, H He, L Luo, C Chen, and Y Guo.
    • Department of Neurosurgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China. doctorwanghui@126.com
    • Clin Radiol. 2013 Jan 1;68(1):e15-20.

    AimTo compare the diagnostic performance of 320-detector row computed tomographic angiography (CTA) with digital subtraction angiography (DSA) for the detection and characterization of intracranial aneurysms.Materials And MethodsFifty-two consecutive patients with non-traumatic subarachnoid haemorrhage (SAH) and suspected intracranial aneurysms were evaluated from January 2009 to October 2011. All underwent both 320-detector row volume CTA examination and DSA. CTA volume data were transmitted to a VITREA workstation and two physicians with experience in diagnostic imaging of the nervous system independently carried out image post-processing and assessed the results. The three-dimensional (3D) CTA and DSA images were assessed using intraoperative findings as the reference standard.ResultsIn 52 patients, 54 aneurysms were detected; 48 patients underwent surgery for 50 aneurysms. The overall sensitivity, specificity, and accuracy of 3D CTA were 96.3, 100, and 94.6%, respectively. Meanwhile, the overall sensitivity, specificity, and accuracy of DSA were 98.1, 98.1, and 95.1%, respectively. For aneurysms less than 3 mm, the sensitivity, specificity, and accuracy of 3D CTA were 81.8, 100, and 93.3%, respectively. The sensitivity, specificity, and accuracy of DSA for small aneurysms were 90.9, 100, and 96.2%, respectively. 3D CTA was superior to DSA in demonstrating aneurysmal calcification, parent artery, and surrounding vascular anatomy.Conclusions3D CTA is a highly sensitive, specific, and non-invasive imaging method for diagnosis and evaluation of intracranial aneurysms. It also allows for precise depiction of aneurysm morphology. Therefore, 320-detector row CTA may be used as an alternative to DSA as a first-line imaging technique in patients with SAH.Copyright © 2012 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

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