Document Detail


Accuracy of 16-row multislice computed tomographic angiography for assessment of small cerebral aneurysms.
MedLine Citation:
PMID:  18300898     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Many cases of subarachnoid hemorrhage are the result of rupture of small cerebral aneurysms. The aim of the study was to assess the diagnostic accuracy of 16-row multislice computed tomographic angiography (CTA) in detecting small cerebral aneurysms (<or=5 mm) compared with digital subtraction angiography (DSA), surgical findings, or both. METHODS: One hundred ninety-two consecutive patients underwent CTA for suspected cerebral aneurysms. All aneurysms prospectively detected by CTA were confirmed by DSA or surgery. This was performed with a 16-detector row machine, with a detector slice of 0.75 mm, reconstruction interval of 0.40 mm, and timing determined by bolus trigger. CTA and DSA images were reviewed by two independent, blinded neuroradiologists who performed aneurysm detection, quantitation, and characterization using maximum-intensity projections, shaded-surface display, and volume-rendering techniques reconstructions. RESULTS: Combining CTA, DSA, and intraoperative findings, 64 small cerebral aneurysms (<or=5 mm) were identified in 54 (28%) of the 192 patients. Three small cerebral aneurysms identified on CTA were not clearly depicted at DSA but were confirmed at surgery. The sensitivity, specificity, and accuracy of 16-slice CTA for small aneurysms were all 100% on a per aneurysm basis. The positive predictive value and negative predictive value of 16-slice CTA for small aneurysms were both 100%, respectively, on a per aneurysm basis. There was no statistically significant difference in sensitivity between 16-slice CTA and DSA (P > 0.05). Sixteen-slice CTA images show more clarity and accuracy in the relationship of aneurysms to bone structures and adjacent branch vessels. CONCLUSION: Noninvasive 16-slice CTA is sensitive enough to replace conventional DSA in the triage, diagnosis, and treatment planning in patients with small cerebral aneurysms.
Authors:
Wenhua Chen; Jie Wang; Wei Xin; Ya Peng; Qing Xu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  62     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-02-27     Completed Date:  2008-04-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  113-21; discussion 121-2     Citation Subset:  IM    
Affiliation:
Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China. chewenhua@tom.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Angiography, Digital Subtraction / methods*
Cerebral Angiography
Female
Humans
Intracranial Aneurysm / classification,  radiography*
Male
Middle Aged
Tomography, X-Ray Computed / methods*

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