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Subtraction CT angiography for evaluation of intracranial aneurysms: comparison with conventional CT angiography

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Abstract

The purpose of our study was to compare the diagnostic performance of subtraction computed tomography angiography (CTA) with conventional nonsubtracted CTA and digital subtraction angiography (DSA) for the detection of intracranial aneurysms. A total of 76 patients underwent both subtraction CTA and conventional CTA for the detection and therapy planning of suspected intracranial aneurysms. Subtraction and conventional CTA images were independently assessed by two readers in a blinded manner. The possibility of endovascular treatment or surgical clipping was also assessed based on information provided by CT angiograms alone. In 64 patients, 75 aneurysms were present on DSA. On a per-aneurysm basis, the sensitivity of subtraction CTA was 98.6% for reader 1, and 100% for reader 2. However, sensitivity of conventional CTA was 94.6% for reader 1, and 93.3% for reader 2. Therapeutic decisions could be made regarding 63 patients based on information provided by subtraction CTA images. However, conventional CTA provided sufficient information to make this decision for 55 patients. Conventional CTA has limited sensitivity in detecting very small aneurysms as well as aneurysms adjacent to bone. Subtraction CTA performed on a 64-row multidetector CT is an accurate and promising diagnostic tool that seems to be equivalent to 2D DSA for the detection and pretreatment planning of intracranial aneurysms.

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Acknowledgement

The authors would like to thank Shouqun Hang for careful review of statistical analyses. This work was supported, in part, by a grant from the National Basic Research Program of China (973 Program).

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Authors and Affiliations

  1. Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, 400016, China

    Qi Li, Kewei Li & Peng Xie

  2. Department of Radiology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China

    Fajin Lv, Yongmei Li & Tianyou Luo

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  1. Qi Li
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  2. Fajin Lv
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  3. Yongmei Li
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  4. Kewei Li
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  5. Tianyou Luo
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  6. Peng Xie
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Correspondence to Peng Xie.

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Li, Q., Lv, F., Li, Y. et al. Subtraction CT angiography for evaluation of intracranial aneurysms: comparison with conventional CT angiography. Eur Radiol 19, 2261–2267 (2009). https://doi.org/10.1007/s00330-009-1416-4

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  • DOI: https://doi.org/10.1007/s00330-009-1416-4

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