Evaluation of 64-section CT angiography for detection and treatment planning of intracranial aneurysms by using DSA and surgical findings.
OBJECTIVE
To investigate the diagnostic performance of 64-section computed tomographic (CT) angiography in the detection of intracranial aneurysms.


METHODS
This study was approved by the institutional review board; written informed consent was obtained. One hundred eight consecutive patients suspected of having intracranial aneurysms were recruited. All patients underwent both 64-detector CT angiography and digital subtraction angiography (DSA) for the detection of intracranial aneurysms. CT angiograms were reviewed by two independent blinded readers. Sensitivity, specificity, and positive and negative predictive values for aneurysm detection with CT angiography were calculated by using DSA and surgical findings as the reference standard.


RESULTS
One hundred seven aneurysms were seen in 96 patients. Of those, DSA helped detect 106. On a per-aneurysm basis, the sensitivity, specificity, and positive and negative predictive values for CT angiography were 99%, 100%, and 100% and 92.3%, respectively. For aneurysms smaller than 3 mm, sensitivity was 93.7% for reader 1 and 96.8% for reader 2. However, the sensitivity and specificity were both 100% for aneurysms larger than 3 mm. Therapeutic decisions could be made on the basis of information provided by CT angiography.


CONCLUSIONS
Sixty-four-detector CT angiography is an accurate imaging method for the detection of aneurysms. It may be used as the initial imaging technique in the diagnostic work-up of patients suspected of having intracranial aneurysms.
Li
Qi
Q
Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, 400016 Chongqing, China.
Lv
Fajin
F
Li
Yongmei
Y
Luo
Tianyou
T
Li
Kewei
K
Xie
Peng
P
D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography / Q000379:methods*; D003287:Contrast Media; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging*; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide