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Research ArticleBRAIN

Multi-Section CT Angiography for Detection of Cerebral Aneurysms

Mehmet Teksam, Alexander McKinney, Sean Casey, Martin Asis, Stephen Kieffer and Charles L. Truwit
American Journal of Neuroradiology October 2004, 25 (9) 1485-1492;
Mehmet Teksam
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Alexander McKinney
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Sean Casey
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Martin Asis
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Stephen Kieffer
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Charles L. Truwit
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Abstract

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.

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American Journal of Neuroradiology: 25 (9)
American Journal of Neuroradiology
Vol. 25, Issue 9
1 Oct 2004
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Multi-Section CT Angiography for Detection of Cerebral Aneurysms
Mehmet Teksam, Alexander McKinney, Sean Casey, Martin Asis, Stephen Kieffer, Charles L. Truwit
American Journal of Neuroradiology Oct 2004, 25 (9) 1485-1492;

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Multi-Section CT Angiography for Detection of Cerebral Aneurysms
Mehmet Teksam, Alexander McKinney, Sean Casey, Martin Asis, Stephen Kieffer, Charles L. Truwit
American Journal of Neuroradiology Oct 2004, 25 (9) 1485-1492;
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  • China Intracranial Aneurysm Project (CIAP): protocol for a prospective cohort study of interventional treatment and craniotomy for unruptured aneurysms
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  • Guidelines for the Management of Patients With Unruptured Intracranial Aneurysms: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
  • Interpretation Errors in CT Angiography of the Head and Neck and the Benefit of Double Reading
  • Comparison of Image Quality and Radiation Dose between Fixed Tube Current and Combined Automatic Tube Current Modulation in Craniocervical CT Angiography
  • Effectiveness and costs of screening for aneurysms every 5 years after subarachnoid hemorrhage
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