title: Computerized Tomographic Angiography for Detection of Cerebral Vasospasm after Ruptured Intracranial Aneurysm.
abstract: OBJECTIVE
  Digital subtraction angiography (DSA) is the gold standard to diagnose cerebral vasospasm but it is usually not available due to lack of expertise and proper equipment. The present study aimed to compare the diagnostic accuracy of brain computerized tomographic angiography (CTA) in detecting cerebral vasospasm after intracranial aneurysmal rupture.
  
  
  METHODS
  Between January 2011 and October 2014, 20 patients who were suspected of cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH) were prospectively enrolled. All patients underwent brain CTA andDSA within 24 hours after clinical onset ofvasospasm. Separate reviewers independently reviewed the CTA and DSA.
  
  
  RESULTS
  Twenty patients were enrolled, including 7 males and 13 females. The patient characteristics did not have any relationship to the incidence of cerebral vasospasm. The CTA finding of vasospasm was well correlated to the DSA finding (Kappa 0.793). Diagnostic accuracy and false negative of the CTA were 90% and 5%, respectively. Sensitivity of the CTA was 94% and specificity was 100%. Positive predictive value ofthe CTA was 100% and negative predictive value was 66%. The vessels that showed the most correlation between the CTA and DSA findings were left A1 (Kappa 0.684) and left A2 (Kappa 0.663) segments of anterior cerebral artery, and left M1 (Kappa 0.503) segment of middle cerebral artery. Both CTA and DSA can detect mild vasospasm (< 50% luminal stenosis) located proximal to the circle of Willis.
  
  
  CONCLUSIONS
  Compared to the DSA, the CTA can be used for detecting cerebral vasospasm in patients with ruptured intracranial aneurysms with high sensitivity, specificity, and diagnostic accuracy.
authors.forename: Jiranan
authors.initials: J
authors.lastname: Namyong
authors.forename: Thaweesak
authors.initials: T
authors.lastname: Aurboonyawat
authors.forename: Ekawut
authors.initials: E
authors.lastname: Chankaew
authors.forename: Orasa
authors.initials: O
authors.lastname: Chawalparit
authors.forename: Sirion
authors.initials: S
authors.lastname: Tritrakarn
authors.forename: Prajak
authors.initials: P
authors.lastname: Srirabheebhat
authors.forename: Varisa
authors.initials: V
authors.lastname: Wongbhanuwich
authors.forename: Dittapong
authors.initials: D
authors.lastname: Songsaeng
authors.forename: Julalak
authors.initials: J
authors.lastname: Boonma
mesh_terms: D015901:Angiography, Digital Subtraction; D001921:Brain / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications*; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D020301:Vasospasm, Intracranial / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology*