Preliminary Experience of 256-Row Multidetector Computed Tomographic Angiography for Detecting Cerebral Aneurysms

Abstract

Multidetector computed tomographic angiography (MDCTA) has played an increasing role in detecting cerebral aneurysms. This study was performed to investigate the diagnostic accuracy of the upgraded 256-row MDCTA in the detection of cerebral aneurysms. We identified 93 patients who had undergone both MDCTA and digital subtraction angiography (DSA) before surgery for the detection of cerebral aneurysms. Two and one independent blinded readers reviewed the MDCTA images and DSA images, respectively. The sensitivity, specificity, accuracy, and positive and negative predictive values were calculated for the image interpretation from the two CTA readers and one DSA reader using the combination of DSA and intraoperative findings as the reference standard. A total of 77 intracranial aneurysms were detected in 67 of the 93 patients. The overall sensitivity, specificity, and accuracy of the 256-row MDCTA in the detection of cerebral aneurysms were 96.10%, 92.31%, and 94.23%, respectively. For aneurysms larger than 5 mm, the overall sensitivity, specificity, and accuracy were 100%, 92.31%, and 96.83%, respectively. For aneurysms smaller than 5 mm, the overall sensitivity, specificity, and accuracy were 92.50%, 92.31%, and 92.42%, respectively. There was no significant difference for the sensitivity, specificity, and accuracy of 256-row MDCTA to detect cerebral aneurysm according to the conscious level of the patients. To detect cerebral aneurysms larger than 5 mm, 256-row MDCTA is an imaging method with a satisfactory diagnostic performance equal to that of DSA. However, its diagnostic performance for aneurysms smaller than 5 mm is still inferior to that of DSA.