Comparative analysis of 256-slice CT angiography and 3D digital subtraction angiography in the diagnosis of intracranial aneurysms
10.3969/j.issn.1672-5921.2012.01.005
- Author:
Zheng ZHANG
1
Author Information
1. Department of Neurology
- Publication Type:Journal Article
- Keywords:
Angiography, digital subtraction angiography;
Imaging, three-dimensional;
Intracranial aneurysm;
Tomography, spiral computed
- From:
Chinese Journal of Cerebrovascular Diseases
2012;9(1):21-26
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To compare the values of 256-slice CT angiography (3D-CTA) and 3D digital subtraction angiography (3 D-DSA) in the diagnosis of intracranial aneurysms. Methods: Forty-six patients whose clinical manifestations were highly suspected as subarachnoid hemorrhage (SAH) or suspected as aneurysms on magnetic resonance angiography (MRA) were analyzed retrospectively. Both head 3D-CTA and 3D-DSA were performed in all the patients. Two radiologists independently interpreted the 3D-DSA images of all the patients using double blind method, and the 3D-DSA was interpreted and judged by a neurologist and a radiologist. With the number of aneurysms detected by 3D-DSA as the standard, the sensitivity and specificity of 3D-CTA as well as the consistency of the number of aneurysms detected between the two 3D-CTA readers and between 3D-CTA and 3D-DSA techniques were assessed. In the measurement of the maximum diameter of aneurysms, the measured values of 3D-DSA images were used as the standard to compare the differences of the maximum diameter of aneurysms in the 3D-CTA VR images between the two 3D-CTA readers and to compare those between the 3D-CTA VR images and the 3D-DSA images. Results: Among the 46 patients, 3D-DSA revealed 49 aneurysms in 37 patients and no aneurysm was revealed in the remaining 9 patients. Circled digit oneThe sensitivity and specificity of 3D-CTA in detecting the number of intracranial aneurysms were 91.8%-93.9% and 77.8%-100% respectively. Circled digit twoAs for the aneurysms less than 3 mm, the sensitivity were 83.3% and specificity of 3D-CTA were 77.8%-100% respectively. Circled digit threeFrom the aspect of the detection rate of aneurysms, the consistency was high between the 3D-CTA readers and between the techniques of 3D-CTA and 3D-DSA (κ = 0.730 and κ = 0.686-0.777 respectively). Circled digit fourThe maximum diameter of aneurysms detected with CTA and the measured values of DSA, as well as the measured values of CTA between the two doctors had a high correlation (r = 0.996, all P < 0.001). Conclusion: Both the sensitivity and specificity of aneurysm detection with 256-slice 3D-CTA are high. The aneurysm detection rate and the maximum diameter measurement of 3D-CTA are as high as 3D-DSA, which can be used as the screening method for patients with suspected aneurysm, but the aneurysms with maximum diameter <3 mm may still have false-negative result. When the aneurysms are highly suspected in clinical practice but the results of 3D-CTA suggest negative, 3D-DSA examination is still to be needed.
