Diagnotic application of intracranial aneurysm by 64-detector row CT angiography
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Objective:To evaluate the diagnostic value of 64-detector row computed tomographic angiography(CTA) in intracranial aneurysm compared with the conventional intraarterial digital subtraction angiography(DSA).Methods:64-detector row CT angiography and DSA were performed in 29 patients with suspected intracranial aneurysms.Source images were got by GE light speed VCT scanner and were performed to reconstruct by MPR,VR,TS MIP.CTA reconstruction and DSA images were reviewed by 2 radiologists.Results:A total of 27 aneurysms were confirmed by DSA in 25 patients,in which two patients had two aneurysms.Compared with the results of DSA,26 cerebral aneurysms in 25 patients were found by CTA and I common carotid artery aneurysm was not diagnosed.The size, shape and parent vessel of aneurysm were clearly displayed by CTA.The neck of aneurysm in 3 cases was not displayed by DSA but was in all cases by CTA.Conclusion:64-detector row CTA has very high value in diagnosis,of intracranial aneurysms and has unique advantage in displaying the neck of aneurysm,providing precistic diagnose and treament information.Keywords:
Digital subtraction angiography
Computed tomographic angiography
Computed Tomography Angiography
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Objective To evaluate the clinical value of CT angiography(CTA) in the diagnosis of intracranial aneurysms.Methods Two hundred fifteen patients with intracranial aneurysms confirmed by digital subtraction angiography(DSA) or surgery were included in this study.DSA,CTA and reconstruction of maximum intensity projection(MIP),multiplanar reconstruction(MPR),volume rendering technique(VRT),shaded surface display(SSD) were executed in all cases.Surgery was performed in 207 cases.The results of CTA were compared with DSA and surgical findings.Results Two hundred and thirty-eight aneurysms in 215 cases were confirmed by DSA and surgery.Of 238 aneurysms,230 in 206 cases were correctly diagnosed by CTA,8 missed in 8 cases,and 1 misdiagnosed in one case.230,230,221 and 219 aneurysms were demonstrated by MIP,MPR,VRT and SSD,respectively.Three aneurysms were missed by DSA examination according to operation results.Compared with DSA,the sensitivity and positive predictive value of CTA were 96.6% and 99.6% respectively.There was no statistics difference between CTA and DSA in the diagnosis of intracranial aneurysm.Conclusion CTA is a highly accurate imaging examination for the diagnosis of the location,size and characterization of intracranial aneurysms and it can provide sufficient diagnostic information in guiding the treatment of aneurysms.
Maximum intensity projection
Digital subtraction angiography
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[Objective] To estimate the value of 64-slice spiral CT angiography(CTA) in the diagnosis of intracranial aneurysm. [Methods] 48 patients with subaranoid hemorrahage(SAH) were examined with both CTA and digital subtraction angiography(DSA) . The results of two methods were compared. [Results] No aneurysm was found among eleven patients with SAH by CTA or DSA.A total of 37 aneurysms were detected by CTA in 37 patients and 38 cases were detected by DSA. Two aneurysms were missing in CTA,which were demonstrated in DSA. One aneurysms was misdiagnosed in CTA. Compared with DSA,the sensitivity and specificity of CTA on aneurysm were 94.7% and 91.7%,respectively. [Conclusion] 64-slice spiral CT angiography showed to be a quick,simple and accuracy method for diagnosing intracranial aneurysm.
Digital subtraction angiography
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Objective To evaluate the value of the three-dimensional 16-slice spiral computed tomography angiography (3D- CTA) in the detection and characterization of intracranial aneurysm, and compare with digital substraction angiography (DSA). Methods Seventy-six patients (male 35, female 41, aged 38 - 83 years, mean age 60.5 years) with subarachinoid hemorrhage(SAH) suspected intracranial aneurysm were performed 3D-CTA and DSA. 3D postprocessing included multiplanar reconstruction(MPR), maximum intensity projection(MIP) and volume rendering(VR). Findings of 3D-CTA included number, location, size, relationship to adjancent arteries, mural calcification and thrombus of detected aneurysms. The sensitivity and specificity of 3D-CTA were determined by comparison with results of DSA and operative finding. Results A total of 68 aneurysms were detected in 62 patients. The results of CTA on the location and size of aneurysms were highly consistent with DSA and operative finding. Displaying of the spatial characteristic, mural calcification and thrombus in CTA were more effective than that in DSA. Conclusion There are high sensitivity and specificity of 3D-CTA detecting and characterizing the intracranial aneurysms. It is a rapid, noninvasive, and reliable approach and can be adopted to replace DSA in screening and preoperative assessment for intracranial aneurysms.
Maximum intensity projection
Computed Tomography Angiography
Spiral computed tomography
Computed tomographic angiography
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Introduction: Multi-Detector Computed Tomography (MDCT)
angiography is a non-invasive technique in emergency screening of Subarachnoid Haemorrhage (SAH) for accurately detecting aneurysms. Digital Subtraction Angiography (DSA) remains the gold standard for diagnosis of intracranial aneurysm. Computed Tomography Angiography (CTA) is being increasingly used for this purpose and can presently replace DSA as the most reliable
means to detect intracranial aneurysms in SAH.
Aim: To characterise the morphology of intracranial aneurysms with CTA and to compare it with DSA and intraoperative findings.
Materials and Methods: This analytical study includes
patients suspected to have intracranial aneurysm and
underwent CTA on 16 slice MDCT scanner. Post-processing
Multiplanar Reconstructions (MPR), 3D Volume Rendering
(VR) and Maximum Intensity Projection (MIP) were performed. The findings of CTA findings were compared with DSA and intraoperative/indocyanine angiography images obtained by Leica neurosurgical operating microscope, wherever possible.
Morphological parameters: size (dome, neck, height, dome
to neck ratio, aspect ratio in saccular and length, diameter in fusiform), shape, lobulation, tit, location, thrombosis/ calcification, blood vessels arising, ruptured or not, grade of SAH (modified CT Fischer score) and vasospasm (grade, number/location of vasospastic segments) were assessed and
compared with DSA and intraoperative findings.
Results: In 71 patients, 97 intracranial aneurysms were studied. Saccular aneurysm was the most common and anterior communicating artery (ACOM) was the most common location.
Significant correlation of dome: neck and aspect ratios between CTA and DSA (p=0.0089) was noted. The sensitivity, Positive Predictive Value (PPV) and accuracy of CTA for aneurysm >3 mm was 100%. Two aneurysms <3 mm were missed on CTA, but detected by DSA. Therefore, for aneurysms <3 mm in size, sensitivity was 92.86%, with a PPV and accuracy of 96.3% and 89.66%, respectively. Overall sensitivity of CTA irrespective of size was 97.9%, with 97.9% PPV and 95.9% accuracy was observed.
Conclusion: MDCTA with 3D reconstructions and volume
rendering is the ideal first line imaging modality in non-traumatic SAH for detection of aneurysm with a high degree of accuracy.
DSA can be used to diagnose tiny aneurysms <3 mm if missed on CTA, if there is a high degree of suspicion.
Maximum intensity projection
Digital subtraction angiography
Computed Tomography Angiography
Anterior communicating artery
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Objective:To assess the diagnostic accuracy of 16-slice computed tomographic angiography(CTA) in detecting intracranial aneurysms compared with digital subtraction angiography(DSA) and surgical findings.Methods:356 cases with suspected intracranial aneurysms received CT scan,and the results were compared to DSA and intraoperative findings retrospectively.Results:Combining CTA,DSA and intraoperative findings,215 aneurysms were detected in 195 of the 356 patients.Five aneurysms were missed when using CTA.Nine aneurysms detected by CTA were not clearly displayed at DSA,five were proved at surgery and four were not performed by surgical treatment.There was no significant difference in sensitivity between 16-slice CTA and DSA.Conclusion:16-slice CTA has a very high sensitivity,specificity,and accuracy of detecting aneurysms,and it is sensitive enough to replace conven-tional DSA in the triage,diagnosis,and treatment planning in patients with intracranial aneurysms.
Computed tomographic angiography
Digital subtraction angiography
Multislice
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Objective To evaluate the value of multislice spiral CTA in diagnosis of intracranial aneurysm.Methods CTA data in 32 patients with intracranial aneurysms proved by operation and DSA were retrospectively analysed in comparison with the results of DSA.Results 38 aneurysms in 32 patients were detected by DSA and operation.Six cases of 32 had two aneurysms.36 and 34 aneurysms were detected by DSA and CTA respectively.4 aneurysms located at anterior communicating artery,7 at middle cerebral artery,9 at posterior communicating artery,14 at internal carotid artery and 4 at basilar artery.Conclusion MSCTA can be used as the method in screening intracranial aneurysms for surgery and interventional therapy.
Digital subtraction angiography
Posterior communicating artery
Multislice
Anterior communicating artery
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The purpose of our study was to compare findings of 64 detector cranial computed tomographic angiography (CTA) and conventional digital subtraction angiography (DSA) mainly in patients with acute subarachnoid hemorrhage (SAH) headache and diplopia. Between March 2007 and May 2009, 65 consecutive patients were admitted with clinical symptoms and signs of intracranial aneurysm. 44 of 67 detected aneurysms were confirmed during surgery or endovascular embolization. DSA was performed in the 3 days after CTA. CT angiograms and conventional angiographies were studied by two radiologists, who performed aneurysm detection and characterisation of morphological features. Using CTA and DSA, we detected 67 aneurysms in 50 patients. 15 patients did not have any aneurysms in both DSA and CTA. There was no difference between the two modalities in the number of the detected aneurysms. But two aneurysms were falsely located before surgery with CTA. They were located in posterior communicating artery (PcoA) but, had been thought to be located at the internal carotid artery supraclinoid segment at CTA. CTA has an equal sensitivity as DSA in the detection of intracranial aneurysms. It has 100% detection rate in anterior communicating artery and middle cerebral artery bifurcation aneurysms, but aneurysms at some locations, like the ones at PcoA, were hard to detect with CTA. DSA preserves its diagnostic value for detection of posterior circulation aneurysms.
Digital subtraction angiography
Posterior communicating artery
Computed tomographic angiography
Anterior communicating artery
Anterior choroidal artery
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Objective To investigate the diagnostic evaluation of 64-slice CT angiography(CTA)technique on the intracranial aneurysm in patients with nontraumatic subarachnoid hemorrhage(SAH).Methods 48 patients with nontraumatic SAH were received CTA.The original images were studied,and the VR,MIP,MPR(cMPR)techniques were used to reconstruct the images.All the patients CTA results were compared with those of DSA and(or)operation.Results Of all the 48 patients,39(39/48)patients with aneurysms were detected.The results of DSA and operation were identical to those of CTA.Conclusion 64-slice spiral CTA has very high sensitivity,specificity,and accuracy in detecting aneurysms,and maybe replace conventional DSA.
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To assess the diagnostic performance of 64-section computed tomography angiography (CTA) for detection of cerebral aneurysms by comparison with the new gold standard three-dimensional (3D) digital subtraction angiography (DSA).A total of 128 patients who underwent both 64-section CTA and 3D DSA for suspected intracranial aneurysms were included. The location, size, and shape of the aneurysm were assessed and compared with 3D DSA results. The sensitivity, specificity, positive and negative predictive values of 64-section CTA were calculated by using 3D DSA as reference standard.According to the reference standard, a total of 145 aneurysms were detected at 3D DSA in 118 patients. Of these 145 aneurysms, 64-section CTA detected 139 aneurysms in 118 patients. The sensitivity of CTA for detection of aneurysm was 95.8% on a per-aneurysm basis. All missed aneurysms were non-causative very small aneurysms in patients harboring multiple aneurysms. On a per-patient basis, the sensitivity, specificity, positive and negative predictive values were 100%.Compared with the new gold standard 3D DSA, 64-section CTA offers high sensitivity and specificity for detection of intracranial aneurysms. It could be readily used as a screening imaging method for detection of intracranial aneurysms.
Digital subtraction angiography
Gold standard (test)
Computed Tomography Angiography
Rotational angiography
Subtraction
Positive predicative value
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【Objective】To evaluate the multi-slice spiral CT angiography (CTA) in the diagnosis of intracranial aneurysm. 【Methods】34 patients with clinically suspected intracranial aneurysm were evaluated by 16 slice spiral CTA, 8 cases underwent digital subtraction angiography (DSA) simultaneously. The data were reconstructed by using volume rendering (VR), maximum intensity projection (MIP) and surface shadow display (SSD). The quality of the reconstructions was compared with digital subtraction angiography (DSA) and surgical findings.【Results】Of the 34 patients, 36 aneurysms were detected by CTA. One patient had multiple (n = 2) and the others had solitary a- neurysm. The diameters of the aneurysms were from 2. 0 mm to 23 mm. Of the 8 patients having DSA, the DSA findings were the same as that of CTA in 7 patients; in one patient, the aneurysm was missed by CTA. The neck of aneurysm in 2 cases was not displayed by DSA but was in all cases by CTA. 【Conclusions】Multi-slice spiral CT angiography is an accurate, rapid and noninvasive method for detecting intracranial aneurysm, especially in the emergency situation, and has unique advantage in displaying the neck of aneurysm. Providing precistic diagnose and treament information.
Digital subtraction angiography
Maximum intensity projection
Computed tomographic angiography
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