Acute subarachnoid haemorrhage : detection of aneurysms of intracranial arteries by computed tomographic angiography
Akutna subarohnoidna krvavitev : odkrivanje anevrizem na intrakranialnih arterijah z računalniškotomografsko angiografijo

english

1999

volume 33, issue 4

Onkološki inštitut Ljubljana

Background. We wanted to determine the diagnostic accuracy, sensitivity and specificity of computed tomographic angiography (CTA) of intracranial vessels,and to establish the advantages and disadvantages of CTA compared to digital subtraction angiography (DSA) as the gold standard in patients with acute subarachnoid haemorrhage (SAH). Patients and methods. We prospectively studied 52 patients with acute SAH. Confirmation of the haemorrhage by a conventional computed tomography (CT) scan was immediately followed by intracranial CTA. DSA was performed after the CTA examination and so did not influence the interpretation of CTA images. The sensitivity, specificity and diagnostic accuracy of CTA were determined by comparing the results with the data from DSA and with the surgical findings. Cases where the CTA and DSA results did not match were analysed, and the advantages and disadvantages of intracranial CTA were determined. Results. The diagnostic accuracy of CTA was 95%, its sensitivity was 93%, and its specificity was 98%. False-negative results were obtained in three patients who harboured small aneurysms, two in the region of the cavernous sinus and one at the division of pericallosal and callosomarginal arteries. In one patient with a false-positive result, DSA showed an infundibular widening of the posterior communicating artery. In all seven patients who underwent operations on the basis of CTA results, the surgical findings confirmed the presence of aneurysms as well as the intracranial vessel anatomy demonstrated by CTA. Conclusions. Intracranial CTAis a fast and minimally invasive method with a high diagnostic accuracy, sensitivity and specificity, which has an important place in the detection andpreoperative evaluation of intracranial aneurysms in patients with acute SAH.

10.11.2023