American Journal of Neuroradiology 25:1485-1492, October 2004
© 2004 American Society of Neuroradiology
BRAIN
Multi-Section CT Angiography for Detection of Cerebral Aneurysms
a Department of Radiology, University of Minnesota, Minneapolis, MN
b Department of Radiology, Baskent University Medical School, Ankara, Turkey
Address reprint requests to: Mehmet Teksam, MD, Baskent University Medical School, Department of Radiology, Fevzi Cakmak Cd.10.Sok.No:45, Bahcelievler, Ankara 06490, Turkey
BACKGROUND AND PURPOSE: Multi-section CT has great potential for use in vascular studies. Our purpose was to determine the accuracy of multi-section CT angiography in detecting cerebral aneurysms compared with digital subtraction angiography or surgery.
METHODS: One hundred consecutive patients who underwent multi-section CT angiography and either digital subtraction angiography or surgery were included in the study. Multi-section CT angiography and digital subtraction angiography results were evaluated independently by different neuroradiologists who performed aneurysm detection, quantitation, and characterization by using 2D multiplanar reconstructions, 3D maximum intensity projection, and volume-rendered techniques.
RESULTS: When using intra-arterial digital subtraction angiography or surgery, 113 aneurysms (true positives and false negatives) were detected in 83 of the 100 patients. A total of 106 aneurysms (true positives) were confirmed by using digital subtraction angiography or surgery, or both. Seven aneurysms were missed when using multi-section CT angiography. Eight aneurysms were not confirmed by digital subtraction angiography and were considered to be false positive evaluations. The sensitivity for detecting aneurysms <4 mm, 4 to 10 mm, and >10 mm on a per-aneurysm basis was 0.84 (95% confidence interval: 0.72, 0.92), 0.97 (95% confidence interval: 0.91, 0.99), and 1.00 (95% confidence interval: 0.88, 1.00), respectively. The sensitivity, specificity, and accuracy of multi-section CT angiography for detecting aneurysms on a per-patient basis were 0.99 (95% confidence interval: 0.96, 1.00), 0.88 (95% confidence interval: 0.69, 0.94), and 0.98 (95% confidence interval: 0.95, 1.00), respectively.
CONCLUSION: Multi-section CT angiography has a high sensitivity in detecting aneurysms (especially aneurysms >3 mm). However, CT angiography is currently not sensitive enough to replace digital subtraction angiography.
This article has been cited by other articles:
 |
|
 |
|
  Q. Li, F. Lv, Y. Li, T. Luo, K. Li, and P. Xie Evaluation of 64-Section CT Angiography for Detection and Treatment Planning of Intracranial Aneurysms by Using DSA and Surgical Findings Radiology, June 9, 2009; (2009) 2523081911. [Abstract] [Full Text]
|
|
|
|
 |
|
 M. J.H. Wermer, H. Koffijberg, I. C. van der Schaaf, and For the ASTRA Study Group Effectiveness and costs of screening for aneurysms every 5 years after subarachnoid hemorrhage Neurology, May 27, 2008; 70(22): 2053 - 2062. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A.M. McKinney, C.S. Palmer, C.L. Truwit, A. Karagulle, and M. Teksam Detection of Aneurysms by 64-Section Multidetector CT Angiography in Patients Acutely Suspected of Having an Intracranial Aneurysm and Comparison with Digital Subtraction and 3D Rotational Angiography AJNR Am. J. Neuroradiol., March 1, 2008; 29(3): 594 - 602. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M. McKinney, C. L. Truwit, C. S. Palmer, M. Teksam, K. Papke, C. K. Kuhl, M. Fruth, C. Haupt, M. Schlunz-Hendann, D. Sauner, et al. Intracranial Aneurysms: Is the Diagnostic Accuracy Rate of Multidetector CT Angiography Equivalent to That of Three-dimensional Rotational Conventional Angiography? Radiology, March 1, 2008; 246(3): 982 - 984. [Full Text] [PDF]
|
|
|
|
 |
|
 K. Nael, J. P. Villablanca, L. Mossaz, W. Pope, A. Juncosa, G. Laub, and J. P. Finn 3-T Contrast-Enhanced MR Angiography in Evaluation of Suspected Intracranial Aneurysm: Comparison with MDCT Angiography Am. J. Roentgenol., February 1, 2008; 190(2): 389 - 395. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Romijn, H.A.F. G. van Andel, M.A. van Walderveen, M.E. Sprengers, J.C. van Rijn, W.J. van Rooij, H.W. Venema, C.A. Grimbergen, G.J. den Heeten, and C.B. Majoie Diagnostic Accuracy of CT Angiography with Matched Mask Bone Elimination for Detection of Intracranial Aneurysms: Comparison with Digital Subtraction Angiography and 3D Rotational Angiography AJNR Am. J. Neuroradiol., January 1, 2008; 29(1): 134 - 139. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Lubicz, M. Levivier, O. Francois, P. Thoma, N. Sadeghi, L. Collignon, and D. Baleriaux Sixty-Four-Row Multisection CT Angiography for Detection and Evaluation of Ruptured Intracranial Aneurysms: Interobserver and Intertechnique Reproducibility AJNR Am. J. Neuroradiol., November 1, 2007; 28(10): 1949 - 1955. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D.Y. Yoon, K.J. Lim, C.S. Choi, B.M. Cho, S.M. Oh, and S.K. Chang Detection and Characterization of Intracranial Aneurysms with 16-Channel Multidetector Row CT Angiography: A Prospective Comparison of Volume-Rendered Images and Digital Subtraction Angiography AJNR Am. J. Neuroradiol., January 1, 2007; 28(1): 60 - 67. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B.F. Tomandl, T. Hammen, E. Klotz, H. Ditt, B. Stemper, and M. Lell Bone-Subtraction CT Angiography for the Evaluation of Intracranial Aneurysms AJNR Am. J. Neuroradiol., January 1, 2006; 27(1): 55 - 59. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. J. H. Wermer, I. C. van der Schaaf, B. K. Velthuis, A. Algra, E. Buskens, and G. J. E. Rinkel Follow-up screening after subarachnoid haemorrhage: frequency and determinants of new aneurysms and enlargement of existing aneurysms Brain, October 1, 2005; 128(10): 2421 - 2429. [Abstract] [Full Text] [PDF]
|
|