University of Erciyes, School of Medicine, Department of Radiology, Kayseri, Turkey.
Eur J Radiol. 2011 Nov;80(2):455-61. doi: 10.1016/j.ejrad.2010.07.012. Epub 2010 Aug 21.
The aim of this study is to compare the diagnostic performance of 16-row computed tomographic angiography (MDCTA) with digital subtraction angiography (DSA) for the detection and characterization of intracranial aneurysms in patients with nontraumatic subarachnoid hemorrhages (SAH).
One-hundred and twelve consecutive patients with suspected intracranial aneurysm underwent both 16-row MDCTA and DSA. The MDCT angiograms were interpreted in a blinded fashion by using combination with VRI, MIP and MPR techniques. Sensitivity specificity and accuracy were calculated for the CTA and DSA. The results were compared with each other. The DSA reader's interpretation was accepted as the reference standard.
A total of 164 aneurysms were detected at DSA in 112 patients, no aneurysms were detected by DSA and MDCTA in 16 patients. Eight aneurysms were missed by MDCTA. The overall sensitivity, specificity, and accuracy of MDCTA on a per-aneurysm basis were 95.1%, 94.1%, and 95%, respectively. According to the size of the aneurysm less than 3mm; sensitivity, specificity and diagnostic accuracy of MDCTA were 86.1%, 94.1%, 88.6%, respectively.
This study suggests that MDCTA is equally as sensitive as DSA in the detection of intracranial aneurysms of greater than 3mm, and it also reveals 100% detection rate for ruptured aneurysms.
本研究旨在比较 16 层 CT 血管造影（MDCTA）与数字减影血管造影（DSA）在检测和诊断非创伤性蛛网膜下腔出血（SAH）患者颅内动脉瘤中的诊断性能。
112 例疑似颅内动脉瘤的连续患者均行 16 层 MDCTA 和 DSA 检查。采用 VRI、MIP 和 MPR 技术联合对 MDCT 血管造影进行盲法解读。计算 CTA 和 DSA 的敏感性、特异性和准确性。并将结果相互比较。以 DSA 阅读者的解读作为参考标准。
112 例患者中，DSA 共检出 164 个动脉瘤，16 例患者未检出动脉瘤。MDCTA 漏诊 8 个动脉瘤。以动脉瘤为单位，MDCTA 的总体敏感性、特异性和准确性分别为 95.1%、94.1%和 95%。根据动脉瘤的大小<3mm，MDCTA 的敏感性、特异性和诊断准确性分别为 86.1%、94.1%和 88.6%。
本研究表明，MDCTA 在检测大于 3mm 的颅内动脉瘤方面与 DSA 同样敏感，且对破裂动脉瘤具有 100%的检出率。
