Document Detail


Detection and evaluation of intracranial aneurysms with 16-row multislice CT angiography: comparison with conventional angiography.
MedLine Citation:
PMID:  18463904     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of our study was to compare multidetector row computed tomography (CT) angiography (MDCTA) with digital subtraction angiography (DSA) in the detection and characterization of intracranial aneurysms. Between September 2005 and May 2007, 55 consecutive patients with suspected intracranial aneurysms underwent conventional DSA and MDCTA. Thirty-two women and 23 men were enrolled in the study. The mean patient age was 54 (range = 26-79 years). All MDCTA and DSA images were independently evaluated on a workstation by two radiologists, who had 8 and 6 years of experience in CT vascular imaging and angiography. Using DSA as the gold standard, the sensitivity and specificity of CT angiography was calculated for each reader with 95% confidence intervals. The sensitivity was also calculated for aneurysms smaller than 3 mm with 95% confidence intervals. The agreement between the readers for detecting aneurysms was calculated using kappa statistics. A kappa statistic greater than 0.75 was considered an excellent agreement beyond chance, a kappa statistic of 0.4-0.75, fair to good agreement, and a kappa statistic less than 0.4, poor agreement. At DSA, 64 aneurysms were present in 50 patients involved in the study; seven patients had two aneurysms each, and four patients had three aneurysms each. In five patients, no aneurysm was detected by using MDCTA and DSA, and evaluations were considered as true negative by MDCTA. These five patients also had negative findings at repeat DSA. For readers 1 and 2, the sensitivity of MDCT in detecting aneursyms were 96.9% (95% CI = 89.3-99.1%; 62 of 64) and 98.4 % (95% CI = 91.7-99.7%; 63 of 64), respectively. The spescificity was100% (95% CI = 99.7-100%; 1,256 of 1,256) for both readers. The kappa value indicating interobserver agreement was in the category of excellent (kappa = 0.99 (95% CI = 0.97-1). Regarding the aneurysms smaller than 3 mm, for readers 1 and 2, the sensitivities were 84.6% (95% CI = 57.8-95.7%; 11 of 13) and 92.3% (95% CI = 66.7-98.6; 12 of 13), respectively. MDCTA is accurate in the detection and characterization of intracranial aneurysms and can be used as a reliable alternative imaging technique to DSA. A strategy of using CT angiography as the primary method, with DSA reserved for any cases of uncertainty, appears safe and reliable.
Authors:
Ender Uysal; Fatma Oztora; Alper Ozel; Sukru Mehmet Erturk; Hakan Yildirim; Muzaffer Basak
Related Documents :
10318714 - Contrast-enhanced carotid mr angiography. imaging principles and physics.
10628954 - Model-based quantitation of 3-d magnetic resonance angiographic images.
15185174 - Magnetic resonance angiography.
12500274 - Stenosis detection in forearm hemodialysis arteriovenous fistulae by multiphase contras...
21830054 - Follow-up ct findings of recurrent familial gigantiform cementoma of a female child.
21317564 - Imaging of talar dome chondral and osteochondral lesions.
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-05-08
Journal Detail:
Title:  Emergency radiology     Volume:  15     ISSN:  1070-3004     ISO Abbreviation:  Emerg Radiol     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-15     Completed Date:  2009-01-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9431227     Medline TA:  Emerg Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  311-6     Citation Subset:  IM    
Affiliation:
Department of Radiology, Sisli Etfal training and Research Hospital, Sisli, Istanbul, Turkey. enderuysaltr@yahoo.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angiography, Digital Subtraction
Cerebral Angiography / methods*
Female
Humans
Intracranial Aneurysm / radiography*
Male
Middle Aged
Observer Variation
Sensitivity and Specificity
Tomography, X-Ray Computed / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Transjugular biopsy of an atypical focal nodular hyperplasia in a patient with acute liver failure c...
Next Document:  Emergency percutaneous treatment in surgical bile duct injury.