Application Of 64-row CT Angiography In The Diagnosis And Treatment Of Intracranial Aneurysm

ObjectiveThe aim of our study was to evaluate the value of multi-detector CT angiography (MDCTA) in the diagonosis of intracranial aneurysm, so as to assess the value of MDCTA in the treatment of intracranial aneurysm.MethodsFrom October 2009 to April 2010, 34 consecutive patients with nontraumatic subarachnoid hemorrhage (SAH) who underwent both MDCTA and digital substraction angiography (DSA) were included in the study. Three radiologists with different experience in vascular diagnostic radiology reviewed CT images by double blind method, and 2 neuroradiologists who were blinded to the CT angiographic results reviewed DSA images together. The feature of aneurysm and the width of its dome (D) and neck (N) were getted. Sensitivity, specificity, and positive and negative predictive values for aneurysm detection with MDCTA were calculated by using DSA and surgical findings as the reference standard. Intraclass correlation coefficient (ICC) was also calculated to assess agreements of MDCTA.ResultsDSA revealed 29 aneurysms in 28 patients and no aneurysm in 6 patients. Seven aneurysms at anterior communicating artery, 11 at posterior communicating artery, 3 at internal carotid artery, 2 at anterior cerebral artery, 2 at middle cerebral artery, 1 at posterior cerebral artery, 2 at vertebral-basilar artery, 1 at anterior choroidal artery were detected. Smallest aneurysm measured 1.6 mm and largest measured 11.9 mm (mean,4.99±2.41 mm),of them, nine aneurysms were large, 16 were small,and 4 were very small. Mean sensitivity and specificity of MDCTA for the detection of intracranial aneurysms were, respectively, 97.70% and84.92%. For aneurysms less than 3 mm, mean sensitivity and specificity of MSCTA were, respectively, 83.33% and 84.92%. For the detection of aneurysms, intero-bserver and inter-technique agreements of mean ICC were, respectively, 0.816 and 0.847. Inter-observer and Inter-technique agreements of mean ICC were, respectively, 0.913 and 0.916for the measurement of aneurysm dome and 0.772and 0.781for the measurement of their necks. Observer at inter-time agreements of mean ICC for the measurement of aneurysm dome and their necks were, respectively, 0.943 and 0.872.Conclusion1,MDCTA was an imaging method not only had a high sensitivity and specificity for the detection ruptured intracranial aneurysms but also with a better agreements for the detection of aneurysms and the measurement of their necks and with a very good agreements for the measurement of aneurysm dome.2,MDCTA has a special advantages in detection and therapy planning of intracranial aneurysms. MDCTA was not only an accurate imaging method for the detection of aneurysms, which can replace DSA, but also a useful imaging method for neuroradiologists making reasonable and effective treatment decision by the information that MDCTA provided, so as to improve the curative effect, reduce mortality and morbidity.