Comparison of 16-row multislice CT angiography with conventional angiography for detection and evaluation of intracranial aneurysms

Dönmez, Halil; Serifov, Elman; Kahriman, Güven; Mavili, Ertuğrul; Durak, Ahmet Candan; Menkü, Ahmet

doi:10.1016/j.ejrad.2010.07.012

Cited by 59 publications

(45 citation statements)

References 19 publications

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“…104 Indications for magnetic resonance angiography in aSAH are still few because of limitations with routine availability, logistics (including difficulty in scanning acutely ill patients), predisposition to motion artifact, patient compliance, longer study time, and cost. Aneurysms Ͻ3 mm in size continue to be unreliably demonstrated on computed tomographic angiography (CTA), 105,106 and this generates continued controversy in the case of CTA-negative aSAH. 107 In cases of perimesencephalic subarachnoid hemorrhage (SAH), some authors claim that a negative CTA result is sufficient to rule out aneurysmal hemorrhage and that cerebral angiography is not required, but this is controversial.…”

Section: Clinical Manifestations and Diagnosis Of Asahmentioning

confidence: 99%

Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage

Connolly¹,

Rabinstein²,

Carhuapoma³

et al. 2012

Stroke

2,873

1,375

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Purpose— The aim of this guideline is to present current and comprehensive recommendations for the diagnosis and treatment of aneurysmal subarachnoid hemorrhage (aSAH). Methods— A formal literature search of MEDLINE (November 1, 2006, through May 1, 2010) was performed. Data were synthesized with the use of evidence tables. Writing group members met by teleconference to discuss data-derived recommendations. The American Heart Association Stroke Council's Levels of Evidence grading algorithm was used to grade each recommendation. The guideline draft was reviewed by 7 expert peer reviewers and by the members of the Stroke Council Leadership and Manuscript Oversight Committees. It is intended that this guideline be fully updated every 3 years. Results— Evidence-based guidelines are presented for the care of patients presenting with aSAH. The focus of the guideline was subdivided into incidence, risk factors, prevention, natural history and outcome, diagnosis, prevention of rebleeding, surgical and endovascular repair of ruptured aneurysms, systems of care, anesthetic management during repair, management of vasospasm and delayed cerebral ischemia, management of hydrocephalus, management of seizures, and management of medical complications. Conclusions— aSAH is a serious medical condition in which outcome can be dramatically impacted by early, aggressive, expert care. The guidelines offer a framework for goal-directed treatment of the patient with aSAH.

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Section: Clinical Manifestations and Diagnosis Of Asahmentioning

confidence: 99%

Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage

Connolly¹,

Rabinstein²,

Carhuapoma³

et al. 2012

Stroke

2,873

1,375

View full text Add to dashboard Cite

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“…7,15,16 However, it still seems unclear whether BSCTA can provide sufficient information for therapy decisions, making diagnostic DSA redundant. 17,18 We therefore tested the hypothesis that BSCTA is as accurate as DSA for the identification and characterization of cerebral aneurysms in patients with SAH, even for small aneurysms and for those at the level of the skull base. We additionally studied the reliability of BSCTA and radiation-exposure reduction by avoiding diagnostic DSA.…”

mentioning

confidence: 99%

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

Aulbach

Mucha

Engellandt

et al. 2015

AJNR Am J Neuroradiol

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“…Non-subtraction multi-detector CTA has a relatively high sensitivity and specificity for the detection of cerebral aneurysms (6)(7)(8); however, the detection of aneurysms adjacent to bone remains a challenging issue due to overlying bone structures. To potentially circumvent this limitation, a number of bone removal techniques, including subtraction and manual or automated bone editing, have been developed; however, these methods are associated with several disadvantages, such as the complexity of use, dependence on the user and the high dose of radiation.…”

Section: Per-patientmentioning

confidence: 99%

“…There have been several reports on the potential usefulness of subtraction CTA in evaluating intracranial aneurysms; however, the results of these studies have been varied (6)(7)(8). The purpose of this meta-analysis was to calculate the sensitivity and specificity of subtraction CTA for the detection of cerebral aneurysms, in comparison with the reference standard of DSA.…”

Section: Introductionmentioning

confidence: 99%

“…Computed tomography angiography (CTA), as a relatively non-invasive imaging method, has been widely used in the screening of patients with suspected intracranial aneurysms (6). As a result of the rapid improvement in multi-detector CTA technology, the diagnostic performance of multi-detector CTA for the detection of intracranial aneurysms is now approaching that of DSA (7); however, it exhibits a disadvantage in the detection of small-sized aneurysms that are located near the skull base due to the influence of overprojecting bone structures (8).…”

Section: Introductionmentioning

confidence: 99%

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Subtraction CT angiography for the detection of intracranial aneurysms: A meta-analysis

Feng

Han

Lang

et al. 2016

Experimental and Therapeutic Medicine

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Abstract. The aim of this meta-analysis was to investigate the accuracy of subtraction computed tomography angiography (CTA) for diagnosing intracranial aneurysms. A systematic literature search up to January 1, 2013 was performed in PubMed. Two independent reviewers selected 8 studies that compared subtraction CTA with digital subtraction angiography. Data from the studies were used to construct a 2x2 contingency table on a per-patient basis in ≥5 diseased and 5 non-diseased patients, with additional data on a per-aneurysm basis. Overall, subtraction CTA had a pooled sensitivity of 99% [95% confidence interval (CI), 95-100%] and specificity of 94% (95% CI, 86-97%) for detecting and ruling out cerebral aneurysms, respectively, on a per-patient basis. On a per-aneurysm basis, the pooled sensitivity was 96% (95% CI, 90-99%), and the specificity was 91% (95% CI, 85-95%).In conclusion, subtraction CTA is a highly sensitive, specific and non-inva sive method for the diagnosis and evaluation of intracranial aneurysms. IntroductionThe prevalence of cerebral aneurysm in the general population is estimated to be 1-5% (1). Ruptured intracranial aneurysms are the most important cause of non-traumatic subarachnoid hemorrhage, which is a medical emergency and can result in severe disability or mortality (2). Thus, the prompt diagnosis and treatment of intracranial aneurysm are of considerable importance for the outcome of the patient.Conventional digital subtraction angiography (DSA) has been considered the gold standard for the detection and characterization of intracranial aneurysms due to its high spatial resolution and large field of view (3,4); however, it also has several disadvantages, including the relatively high cost and the high skill level required to perform the procedure. Furthermore, DSA is an invasive procedure associated with a small but definite risk of neurological morbidity (5). There is a requirement, therefore, to find an accurate, minimally invasive imaging method that is free from these complications. Computed tomography angiography (CTA), as a relatively non-invasive imaging method, has been widely used in the screening of patients with suspected intracranial aneurysms (6). As a result of the rapid improvement in multi-detector CTA technology, the diagnostic performance of multi-detector CTA for the detection of intracranial aneurysms is now approaching that of DSA (7); however, it exhibits a disadvantage in the detection of small-sized aneurysms that are located near the skull base due to the influence of overprojecting bone structures (8).As CT technology has evolved and various subtraction and post-processing techniques have been developed, subtraction CTA, allowing bone-free visualization of aneurysms, has become possible for the diagnosis of intracranial aneurysms. There have been several reports on the potential usefulness of subtraction CTA in evaluating intracranial aneurysms; however, the results of these studies have been varied (6-8). The purpose of this meta-analysis was to calculate the ...

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Comparison of 16-row multislice CT angiography with conventional angiography for detection and evaluation of intracranial aneurysms

Cited by 59 publications

References 19 publications

Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage

Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage

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

Subtraction CT angiography for the detection of intracranial aneurysms: A meta-analysis

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