title: Detection and characterization of intracranial aneurysms: a 10-year multidetector CT angiography experience in a large center.
abstract: BACKGROUND
  CT angiography (CTA) is increasingly used for the detection, characterization, and follow-up of intracranial aneurysms. A lower threshold to request a CT angiogram may render a patient population that differs from previous studies primarily evaluated with conventional angiography. Our objective was to broaden our knowledge of the factors associated with aneurysm rupture and patient mortality in this population.
  
  
  METHODS
  All CTA studies performed over a 10-year period at a large neurovascular referral center were reviewed for the presence of an intracranial aneurysm. Patient demographics, mortality, CTA indication, aneurysm location, size, and rupture status were recorded.
  
  
  RESULTS
  2927 patients with aneurysms were identified among 29 003 CTAs. 17% of the aneurysms were ruptured at the time of imaging, 24% of aneurysms were incidentally identified, and multiple aneurysms were identified in 34% of patients. Aneurysms most commonly arose from the supraclinoid internal carotid artery (22%), the middle cerebral artery (18%), and the anterior communicating artery (13%). Male sex, age <50 years, aneurysms >6 mm, and aneurysms arising from the anterior communicating artery, posterior communicating artery, or the posterior circulation were independent predictors of aneurysm rupture. Independent mortality predictors included male sex, posterior circulation aneurysms, intraventricular hemorrhage, and intraparenchymal hemorrhage.
  
  
  CONCLUSIONS
  These results indicate that aneurysms detected on CTA that arise from the anterior communicating artery, posterior communicating artery, or the posterior circulation, measure >6 mm in size, occur in men, and in patients aged <50 years are associated with rupture.
authors.affiliation: Interventional Neuroradiology Division, Department of Radiology, Stanford University Hospital, Stanford, California, USA.
authors.forename: Jeremy J
authors.initials: JJ
authors.lastname: Heit
authors.affiliation: Neuroradiology Division, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: R Gilberto
authors.initials: RG
authors.lastname: Gonzalez
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: David
authors.initials: D
authors.lastname: Sabbag
authors.affiliation: Departments of Neurosurgery and Radiology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: H Bart
authors.initials: HB
authors.lastname: Brouwers
authors.affiliation: Department of Neurosurgery, Hospital Infantil Universitario de San Jose, Bogota, Bogota, Columbia.
authors.forename: Edgar Gerardo
authors.initials: EG
authors.lastname: Ordonez Rubiano
authors.affiliation: Neuroradiology Division, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Pamela W
authors.initials: PW
authors.lastname: Schaefer
authors.affiliation: Neurointerventional Radiology Division, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Hirsch
authors.affiliation: Neuroradiology Division, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Javier M
authors.initials: JM
authors.lastname: Romero
mesh_terms: D000368:Aged; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging* / Q000628:therapy; D020771:Anterior Cerebral Artery / Q000000981:diagnostic imaging; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D002533:Cerebral Angiography / Q000379:methods / Q000639:trends*; D002941:Circle of Willis / Q000000981:diagnostic imaging; D000072226:Computed Tomography Angiography / Q000379:methods / Q000639:trends*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging; D061330:Multidetector Computed Tomography / Q000379:methods / Q000639:trends*; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000639:trends*; D013997:Time Factors
keywords: Aneurysm; CT; CT Angiography; Hemorrhage; Subarachnoid