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Computed Tomographic Angiography (CTA) for the Diagnosis of Intracranial Aneurysms, Comparison with Intra Arterial Digital Subtraction Angiography (DSA) and Surgical Findings

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Abstract:

Background and Objective: Spiral CTA is a highly sensitive, specific, fast and noninvasive imaging method for diagnosis and evaluation of aneurysms in cases of acute SAH with suspected intracranial aneu-rysms (ICAs). Patients and methods: We have carried this study to compare multi-slice CT (4row detector) with DSA for diagnosis of intracranial aneurysm. We calculated the accuracy of CTA in early diagnosis of intracranial an-eurysms in 111 patients referred to Tooska Medical imaging center. The CTA results were compared with recent DSA of patients, which was performed in Sho-hada Tajrish hospital. Results of surgical interventions were also included in this study, and the patients were followed up for 6 months. Results: 42 patients (37.8%) were female. The mean (SD) of participants' age was 49.15 (13.67) years, with the min of 12 and max of 84. Overally, the test have the Sensitivity of 94.3%, specificity of 90%, positive likelihood ratio (LR+) = 9.42, negative likelihood ratio (LR-) =0.06, positive predictive value (PPV) = 0.87 and negative predictive value (NPV) =0.95. The above indices was calculated for age and sex sub groups, but there wasn't any statistically significant differences among them (P-value for se =0.69). Conclusion: These results suggest that the CTA has an acceptable accuracy in diagnosis of ICAs. Also, LR+ and LR- show that this test is conclusive and with considering PPV and NPV, we can use it as a valid substitute for DSA in the patients with clinical suspi-cious to ICAs.

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