Detection and characterization of intracranial aneurysms with 16-channel multidetector row CT angiography : A prospective comparison of volume-rendered images and digital subtraction angiography

• Published in: American Journal of Neuroradiology Vol. 28; no. 1; pp. 60 - 67
• Main Authors: YOON, D. Y, LIM, K. J, CHOI, C. S, CHO, B. M, OH, S. M, CHANG, S. K
• Format: Journal Article
• Language: English
• Published: Oak Brook, IL American Society of Neuroradiology 2007
• Subjects: Adult; Aged; Aged, 80 and over; Angiography, Digital Subtraction; Biological and medical sciences; Brain; Cerebral Angiography - methods; Diagnosis, Differential; Female; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Image Processing, Computer-Assisted - methods; Imaging, Three-Dimensional - methods; Intracranial Aneurysm - diagnostic imaging; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Miscellaneous. Technology; Nervous system; Nervous system (semeiology, syndromes); Neurology; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Sensitivity and Specificity; Tomography, Spiral Computed - methods; Image subtraction; Intracranial; Nervous system diseases; Angiography; Radiodiagnosis; Aneurysm; Cardiovascular disease; Digital image; Medical screening; Vascular disease; Prospective; Multidetector scanner; Computerized axial tomography; Comparative study
• ISSN: 0195-6108; 1936-959X; 1432-1920

The aim of our study was to compare multidetector row CT angiography (MDCTA) with digital subtraction angiography (DSA) in the detection and characterization of intracranial aneurysms. In our blinded prospective study, 85 patients with suspected intracranial aneurysm (47 women, 38 men; age range, 19-83 years) underwent both 16-channel MDCTA and DSA. The MDCT angiograms were interpreted for the presence, location, size, ratio of the neck to the dome (N/D ratio), and lobularity of the aneurysms and relationship of the aneurysm with the adjacent arterial branches, by using volume-rendering techniques. MDCTA and DSA images (reference standard) were interpreted by 2 independent readers, and the results were compared. A total of 93 aneurysms were detected at DSA in 71 patients, whereas no aneurysms were detected in 14 patients. Compared with DSA, the overall sensitivity, specificity, and accuracy of MDCTA on a per-aneurysm basis were 92.5%, 93.3%, and 92.6%, respectively, for both independent readers. For aneurysms of <3 mm, however, MDCTA had a sensitivity of 74.1% for reader 1 and 77.8% for reader 2. There was excellent agreement between readers in the detection of aneurysms (kappa = 0.822). In addition, MDCTA was also accurate in determining N/D ratio of aneurysms, aneurysm lobularity, and adjacent arterial branches. MDCTA is accurate in the detection and characterization of intracranial aneurysms and can be used as a reliable alternative imaging technique to DSA in selected cases.