Detection Accuracy of Intracranial Aneurysmswith Three-dimensional CT angiography: Comparison with Surgical Findings
Article Sidebar
Main Article Content
Abstract
Background: Ruptured intracranial aneurysm is the emergency condition and need vascular imaging for diagnosis and surgical planning. Computed tomographic (CT) angiography becomes popular instead of the conventional cerebral angiography. There had no previous study about its accuracy in Lampang Hospital.
Objective: To assess the diagnostic accuracy of the three-dimensional CT angiography for intracranial aneurysms.
Materials and method: The analytic cross-sectional study was conducted on 29 patients whose findings from CT angiography showed intracranial aneurysms and underwent surgery in Lampang Hospital between June 2007 - March 2009. The location and size of aneurysm were retrospectively reviewed and compared with surgical findings. Sensitivity and accuracy for aneurysm detection
were calculated. The non-concordance film was analyzed for the cause of error.
Results: Twenty-seven patients were male and two were female. The mean age was 61 years (range, 37-84). Most patients had subarachnoid hemorrhage. Twenty-four aneurysms were found in CT angiography and concordant with surgical findings. Mean aneurysm size was 6.7 mm (range, 3- 13). The sensitivity, specificity and accuracy of CT angiography for detection of intracranial
aneurysm were 96%, 40% and 86.7% respectively. Misdiagnosis caused by the inappropriate scanning technique and learning curve of radiologist.
Conclusion: CT angiography showed good sensitivity and accuracy for depiction of intracranial aneurysm. It provided information for surgical planning in the patient with ruptured aneurysms.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความที่ส่งมาลงพิมพ์ต้องไม่เคยพิมพ์หรือกำลังได้รับการพิจารณาตีพิมพ์ในวารสารอื่น เนื้อหาในบทความต้องเป็นผลงานของผู้นิพนธ์เอง ไม่ได้ลอกเลียนหรือตัดทอนจากบทความอื่น โดยไม่ได้รับอนุญาตหรือไม่ได้อ้างอิงอย่างเหมาะสม การแก้ไขหรือให้ข้อมูลเพิ่มเติมแก่กองบรรณาธิการ จะต้องเสร็จสิ้นเป็นที่เรียบร้อยก่อนจะได้รับพิจารณาตีพิมพ์ และบทความที่ตีพิมพ์แล้วเป็นสมบัติ ของลำปางเวชสาร
References
Osborn, Anne G. Diagnostic neuroradiology. 1st ed. St Louis:Mosby; 1994.
Saveland H, Hillman J, Brandt. Overall outcome in aneurysmal subarachnoid hemorrhage. J Neurosurg 1992; 76:729-34.
Alberico RA, Patel M, Casey S, Jacobs B, Maguire W, Decker R. Evaluation of the circle of Willis with three-dimensional CT angiography in patients with suspected intracranial aneurysms. Am J Neuroradiol 1995; 16:1571-80
Korogi Y, Takahashi M, Katada K, Ogura Y, Hasuo K, Ochi M, et al. Intracranial aneurysms: detection with three-dimensional CT angiography with volume rendering comparison with conventional angiographic and surgical findings. Radiology 1999; 211:497-506.
Imakita S, Onishi Y, Hashimoto T, Motosugi S, Kuribayashi S, Takamiya M, et al. Subtraction CT angiography with controlled-orbit helical scanning for detection of intracranial aneurysms. Am J Neuroradiol 1998; 19:291-5.
Ogawa T, Okudera T, Noguchi K, Sasaki N, Inugami A, Uemura K, et al. Cerebral aneurysms: evaluation with three-dimensional CT angiography. Am J Neuroradiol 1996; 17:447-54.
Strayle-Batra M, Skalej M, Wakhloo AK, Ernemann U, Klier R, Voigt K. Three-dimensional spiral CT angiography in the detection of cerebral aneurysm. Acta Radiology 1998; 39:233-8.
Kato Y, Katada K, Hayakawa M, Nakane M, Ogura Y, Sano K, et al. Can 3D-CTA surpass DSA in diagnosis of cerebral aneurysm? Acta Neurochir (Wien) 2001; 143:245-50.
Young N, Dorsch NW, Kingston RJ, Markson G, McMahon J. Intracranial aneurysms: evaluation in 200 patients with spiral CT angiography. Eur Radiology 2001; 11:123-30.
Schwartz RB, Tice HM, Hooten SM, Hsu L, Stieg PE. Evaluation of cerebral aneurysms with helical CT: correlation with conventional angiography and MR angiography. Radiology 1994; 192:717-22.
Katada K, Anno H, Koga S, Ikuta K, Ida Y, Yamagishi I. Three-dimensional angioimaging with
helical scanning CT. Radiology 1990; 177 Suppl:364.
Vieco PT, Shuman WP, Alsofrom GF, Gross CE. Detection of circle of Willis aneurysms in patients with acute subarachnoid hemorrhage: comparison of CT angiography and digital subtraction angiography. Am J Roentgenol 1995; 165:425-30.
Liang EY, Chan M, Hsiang JH, Walkden SB, Poon WS, Lam WW, Metreweli C. Detection and assessment of intracranial aneurysms: value of CT angiography with shaded-surface display. Am J Roentgenol 1995; 165:1497-502.
Alberico RA, Patel M, Casey S, Jacobs B, Maguire W, Decker. Evaluation of the circle of Willis with three-dimensional CT angiography in patients with suspected intracranial aneurysms. Am J Neuroradiol 1995; 16:1571-8.
Hope JKA, Wilson JL, Thomson FJ. Three-dimensional CT angiography in the detection and characterization of intracranial berry aneurysms. Am J Neuroradiol 1996; 17:439-45.
Heinz ER. Commentary: prospective evaluation of the circle of Willis with three-dimensional CT angiography in patients with suspected intracranial aneurysms. Am J Neuroradiol 1995; 16:1579-80
Johnson PT, Heath DG, Kuszyk BS, Fishman EK. CT angiography with volume rendering: advantages and applications in splanchnic vascular imaging. Radiology 1996; 200:564-8.