title: 320-detector row CT angiography for detection and evaluation of intracranial aneurysms: comparison with conventional digital subtraction angiography.
abstract: OBJECTIVE
  To 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.
  
  
  METHODS
  Fifty-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.
  
  
  RESULTS
  In 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.
  
  
  CONCLUSIONS
  3D 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.
authors.affiliation: Department of Neurosurgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China. doctorwanghui@126.com
authors.forename: H
authors.initials: H
authors.lastname: Wang
authors.forename: W
authors.initials: W
authors.lastname: Li
authors.forename: H
authors.initials: H
authors.lastname: He
authors.forename: L
authors.initials: L
authors.lastname: Luo
authors.forename: C
authors.initials: C
authors.lastname: Chen
authors.forename: Y
authors.initials: Y
authors.lastname: Guo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods*; D002114:Calcinosis / Q000000981:diagnostic imaging; D002533:Cerebral Angiography / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult