Application of multislice computed tomographic angiography in diagnosis and treatment of intracranial aneurysms

Chen, Wenhua; Yang, Yilin; Xing, Wei; Qiu, Jianguo; Peng, Ya

doi:10.1016/j.clineuro.2010.04.022

« Previous Next »Clinical Neurology and Neurosurgery
Volume 112, Issue 7 , Pages 563-571, September 2010

Application of multislice computed tomographic angiography in diagnosis and treatment of intracranial aneurysms

Wenhua Chen
- Department of Radiology, The Third Affiliated Hospital of Suzhou University, 185 Juqian Street, 213003 Changzhou, Jiangsu Province, PR China
- Corresponding author. Tel.: +86 13861160060; fax: +86 519 86605089.
Yilin Yang
- Department of Neurosurgery, The Third Affiliated Hospital of Suzhou University, 213003 Changzhou, PR China
Wei Xing
- Department of Radiology, The Third Affiliated Hospital of Suzhou University, 185 Juqian Street, 213003 Changzhou, Jiangsu Province, PR China
Jianguo Qiu
- Department of Radiology, The Third Affiliated Hospital of Suzhou University, 185 Juqian Street, 213003 Changzhou, Jiangsu Province, PR China
Ya Peng
- Department of Neurosurgery, The Third Affiliated Hospital of Suzhou University, 213003 Changzhou, PR China

Received 1 March 2009; received in revised form 19 January 2010; accepted 29 April 2010.

Abstract

Objectives

The aim of the study is to assess the clinical value of 16-row multislice computed tomographic angiography (CTA) for detection and treatment of intracranial aneurysms.

Patients and methods

Between January 2005 and October 2008, 388 patients were included and successively underwent 16-slice CTA for suspected intracranial aneurysms. Three neuroradiologists independently reviewed CTA and DSA images. The combined interpretations of digital subtraction angiography (DSA) and surgical findings were considered as the ultimate reference standard against which the diagnostic accuracy of CTA and DSA were compared.

Results

The reference standard revealed 287 aneurysms in 256 patients. There was no statistically significant difference in accuracy between 16-slice CTA and conventional DSA. The sensitivity, specificity, and accuracy of 16-slice CTA in detecting all aneurysms were 98.3, 97.0, and 97.9%, respectively, on a per-aneurysm basis. The sensitivity of 16-slice CTA was 90.0% for reader 1 and 93.3% for reader 2 for less than 3mm aneurysms. One hundred eighty-nine aneurysms were deemed amenable to endovascular therapy on the basis of CTA images, 98% of whom (185) were successfully treated with this method. Forty-eight aneurysms were considered candidates for surgical treatment, and all aneurysms were deemed completely occluded during surgical clipping. Sixteen-slice CTA images provided important preoperative information, which could assist the endovascular and surgical therapy of aneurysms.

Conclusions

Sixteen-slice CTA is a highly accurate imaging examination of the first line imaging technique for the detection of intracranial aneurysms, and it can provide sufficient diagnostic information in guiding the surgical and endovascular therapy of aneurysms.

Keywords: Computed tomography angiography, Digital subtraction angiography, Intracranial aneurysm, Treatment