Li Lu, Presenter: Nothing to Disclose

Long Jiang Zhang MD, Abstract Co-Author: Nothing to Disclose

Guang Ming Lu MD, PhD, Abstract Co-Author: Nothing to Disclose

The purpose of this study was to evaluate the diagnostic accuracy of digital subtraction computed tomography angiography (DS-CTA) in the detection of intracranial aneurysms compared with three-dimensional rotational digital subtraction angiography (3D-DSA) as reference standard in a large cohort in a single center.

Five hundred and thirteen patients with clinically suspected or known intracranial aneurysms or other cerebral vascular diseases underwent DS-CTA performed on a dual source CT scanner followed by 3D-DSA with a median time interval of 1 day. The accuracy of aneurysm detection with DS-CTA was analyzed on a per-patient and a per-aneurysm basis using 3D-DSA as a reference standard. The accuracy of DS-CTA for the detection of aneurysms with the different sizes (the diameter of less than 3 mm, larger than 3 mm but less than 5 mm, larger than 5 mm but less than 10 mm, and larger than 10 mm) and of the aneurysms at different locations of the anterior and posterior circulation were calculated.

In our cohort of 513 patients, 106 patients (21.1%) had no aneurysms, while 407 patients (78.9%) had a total of 459 aneurysms diagnosed on 3D-DSA. DS-CTA correctly detected 456 aneurysms in 513 patients. Using 3D-DSA as the standard of reference, sensitivity and specificity of DS-CTA for detection of intracranial aneurysms were 97.7% and 88.7%, respectively, on a per-patient basis, 96.5% and 87.9% respectively on a per-aneurysm basis. DS-CTA had sensitivities of 91.3%, 94.0%, 98.4%, 100% for the detection of aneurysms with the diameter of less than 3 mm, larger than 3 mm but less than 5 mm, larger than 5 mm but less than 10 mm, and larger than 10 mm. DS-CTA had sensitivities of 95.7% and 97.7% for the detection of aneurysm in the anterior circulation and the posterior circulation, respectively. Excellent inter-modality agreement was found between 3D-DSA and DS-CTA in the detection of intracranial aneurysms (Kappa value= 0.835, P ＜0.001).

On the basis of this large cohort, DS-CTA has a high sensitivity and specificity for detection of intracranial aneurysms of various sizes and at different locations compared with 3D-DSA.

Digital subtraction CT angiography can be the referred as first choice of modality for the noninvasive evaluation of intracranial aneurysms in the patients with acute subarachnoid hemorrhage.

Lu, L, Zhang, L, Lu, G, Digital Subtraction CT Angiography for the Detection of Intracranial Aneurysms in 513 Patients: A Comparison with Three-dimensional Digital Subtraction Angiography  .  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11006446.html