Cerebral Aneurysms: Accuracy of 320–Detector Row Nonsubtracted and Subtracted Volumetric CT Angiography for Diagnosis

Abstract

Subtracted 320-detector row volumetric CT angiography provides excellent sensitivity for detection of cerebral aneurysms and should be the first-line imaging technique for the noninvasive evaluation of aneurysms. The accuracy of nonsubtracted volumetric CT angiography was lower than that for subtracted volumetric CT angiography, especially for aneurysms adjacent to bone tissue.

Diagnostic Impact of Bone-Subtraction CT Angiography for Patients with Acute Subarachnoid Hemorrhage

“…7 Our study results are also in line with those in 2 other studies by using modern dual-source and 320 -detector row BSCTA. 12 In our study, 1 aneurysm of Ͻ3 mm (2.5 mm) in diameter was missed by DSA (Fig 3). Another Ͻ3-mm (1.7 mm) aneurysm was initially missed by BSCTA (Fig 2).…”

“…A recent 320 -detector row BSCTA study evaluated the diagnostic accuracy of nonsubtracted and subtracted volumetric CTA data. 12 The sensitivity for nonsubtracted CTA was 96.7% compared with 99.2% for subtracted CTA with 100% specificity for both.…”

“…CTA has a high sensitivity and specificity in detecting intracranial aneurysms, 8,9,11,12,17,19,20 but skull base structures can hide adjacent aneurysms. 17,21 Bone-subtraction CTA 22,23 has been developed to overcome this problem.…”

“…5,6 Multidetector CT angiography with high spatial resolution and bone-subtraction CTA (BSCTA) approaches the diagnostic accuracy of DSA in the detection of intracranial aneurysms. [7][8][9][10][11][12] Thus, BSCTA can be considered an alternative to DSA in treatment planning. 13,14 Some authors already recommend BSCTA as the primary imaging in acute SAH.…”

Cerebral CTA with Low Tube Voltage and Low Contrast Material Volume for Detection of Intracranial Aneurysms

“…5 Multidetector row CT angiography has always been the primary imaging technique for the evaluation of intracranial aneurysms, especially for the critical patients presenting with subarachnoid hemorrhage, because of its wide availability, reduced imaging time, and high diagnostic accuracy. [4][5][6][7] Even for the patients with headache and near-normal neurologic examination findings, CTA may be important for screening. However, radiation exposure and contrast material-induced nephropathy are inherent drawbacks of CTA.…”