Detection of intracranial aneurysms with two-dimensional and three-dimensional multislice helical computed tomographic angiography.
OBJECTIVE
Computed tomographic angiography (CTA) has become a diagnostic method for the detection of intracranial aneurysms in cases of subarachnoid bleeding. We sought to evaluate the detection of aneurysms with CTA with a novel multislice helical computed tomographic scanner.


METHODS
Prospectively, 179 patients underwent multislice CTA, followed by digital subtraction angiography (DSA) of both carotid arteries with or without the posterior circulation, DSA of one carotid artery with or without the posterior circulation, or DSA of the posterior circulation alone. The total number of carotid arteries studied was 298, and the number of vertebrobasilar arteries studied was 124.


RESULTS
Of 178 aneurysms verified with DSA or intraoperatively, CTA failed to detect 7 aneurysms of 1 to 2 mm and 1 partially thrombosed, 4-mm aneurysm. The sensitivity and specificity of CTA for aneurysm detection were 0.96 and 0.97, respectively.


CONCLUSIONS
The first generation of multislice computed tomographic technology does not improve CTA to surpass DSA for the detection of small aneurysms of 1 to 2 mm. In practice, however, CTA is superior as a fast noninvasive method without complications.
Kangasniemi
Marko
M
Department of Radiology, Helsinki University Central Hospital, Helsinki, Finland. marko.kangasniemi@hus.fi
Mäkelä
Teppo
T
Koskinen
Seppo
S
Porras
Matti
M
Poussa
Kristiina
K
Hernesniemi
Juha
J
D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography / Q000295:instrumentation*; D003951:Diagnostic Errors; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000295:instrumentation*; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging*; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed / Q000295:instrumentation*