title: Detection of intracranial aneurysms with 64 channel multidetector row computed tomography: comparison with digital subtraction angiography.
abstract: OBJECTIVE
  To compare the contribution of 64 channel multidetector row computed tomography angiography (64MDCT-angiography) with digital subtraction angiography (DSA) in the detection of intracranial aneurysms.
  
  
  METHODS
  Twenty-nine patients (10 males and 19 females, age: 40-84 years; average: 61.9 years) with clinical and imaging findings strongly suggesting the presence of subaracnoid hemorrhage underwent 64MDCT-angiography and DSA with a short interval between the two examinations (less than 12 h-5 days). CT parameters were: 64 mm x 0.5 mm collimation, pitch-0.828 and helical pitch-53. DSA were performed with standard technique (four vessel catheterization) and multiple projections. Axial CT scans as well as maximum intensity projection, volume rendering and multiplanar reformations and angiographic views were independently reviewed by four readers (two for 64MDCT-angiography and two for DSA). Consensus was reached for discordant cases. DSA was considered as the standard of reference.
  
  
  RESULTS
  In 29 patients, 28 aneurysms were found (14 patients had 1 aneurysm, 4 patients had 2 aneurysms and 2 patients had 3 aneurysms; in 9 patients no aneurysm were found). 64MDCT-angiography detected 26/28 aneurysms. No false-positive sites were recognized. The sensitivity, specificity, positive and negative predictive values and diagnostic accuracy were, respectively, 92.8, 100, 100, 99.4 and 99.5%.
  
  
  CONCLUSIONS
  64MDCT-angiography is helpful in detecting intracranial aneurysms with results similar to those of DSA but with less discomfort and risks for the patients and can be considered for the first line imaging technique. Conventional angiography is still needed in doubtful cases or negative MDCT-angiography associated with a strong clinical suspect.
authors.affiliation: Struttura Complessa di Radiologia, Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Trieste, Strada di Fiume 447, 34100 Trieste, Italy. fpozzimuce@sirm.org
authors.forename: Fabio
authors.initials: F
authors.lastname: Pozzi-Mucelli
authors.forename: Stefano
authors.initials: S
authors.lastname: Bruni
authors.forename: Marco
authors.initials: M
authors.lastname: Doddi
authors.forename: Antonio
authors.initials: A
authors.lastname: Calgaro
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Braini
authors.forename: Maria
authors.initials: M
authors.lastname: Cova
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*