TY - JOUR
T1 - Subarachnoid hemorrhage: aneurysm detection and preoperative evaluation with CT angiography
T2 - Aneurysm detection and preoperative evaluation with CT angiography
AU - Velthuis, B. K.
AU - Rinkel, G. J.
AU - Ramos, L. M.
AU - Witkamp, T. D.
AU - Berkelbach van der Sprenkel, J. W.
AU - Vandertop, W. P.
AU - van Leeuwen, M. S.
PY - 1998/1/1
Y1 - 1998/1/1
N2 - To evaluate if computed tomographic (CT) angiography can replace digital subtraction angiography (DSA) for aneurysm detection and as preoperative work-up in patients with subarachnoid hemorrhage (SAH). Prospectively, 100 patients with SAH underwent CT angiography; 80 also underwent DSA. Two observers independently evaluated CT angiographic source images and maximum intensity projection slabs. Neurosurgeons compared CT angiograms and DSA images for presurgical evaluation. On CT angiograms, the observers detected 73 and 70 of 75 symptomatic aneurysms; 96% of the detected aneurysms were classified as definitely present. Of 16 incidental aneurysms, 12 and 10 were detected by the observers. With adequate CT angiographic quality, parent artery side of anterior communicating aneurysms was correctly predicted in 100% (95% confidence interval [CI]: 87%, 100%). Neurosurgeons assessed CT angiography as equal or superior to DSA in 83% (95% CI: 73%, 90%) of 87 aneurysms, and in 74% (95% CI: 63%, 82%) operation might have been based on CT angiographic findings alone. CT angiography depicted 90% of all aneurysms, and 90% were classified as definitely present. CT angiography must be of high quality with adequate depiction of the aneurysm and the parent artery for surgery to be performed on the basis of CT angiographic findings alone
AB - To evaluate if computed tomographic (CT) angiography can replace digital subtraction angiography (DSA) for aneurysm detection and as preoperative work-up in patients with subarachnoid hemorrhage (SAH). Prospectively, 100 patients with SAH underwent CT angiography; 80 also underwent DSA. Two observers independently evaluated CT angiographic source images and maximum intensity projection slabs. Neurosurgeons compared CT angiograms and DSA images for presurgical evaluation. On CT angiograms, the observers detected 73 and 70 of 75 symptomatic aneurysms; 96% of the detected aneurysms were classified as definitely present. Of 16 incidental aneurysms, 12 and 10 were detected by the observers. With adequate CT angiographic quality, parent artery side of anterior communicating aneurysms was correctly predicted in 100% (95% confidence interval [CI]: 87%, 100%). Neurosurgeons assessed CT angiography as equal or superior to DSA in 83% (95% CI: 73%, 90%) of 87 aneurysms, and in 74% (95% CI: 63%, 82%) operation might have been based on CT angiographic findings alone. CT angiography depicted 90% of all aneurysms, and 90% were classified as definitely present. CT angiography must be of high quality with adequate depiction of the aneurysm and the parent artery for surgery to be performed on the basis of CT angiographic findings alone
KW - Aneurysm, intracranial
KW - Aneurysm, rupture
KW - Computed tomography (CT), angiography
KW - Computed tomography (CT), clinical effectiveness
KW - Computed tomography (CT), comparative studies
KW - Digital subtraction angiography, comparative studies
UR - http://www.scopus.com/inward/record.url?scp=0031830324&partnerID=8YFLogxK
U2 - https://doi.org/10.1148/radiology.208.2.9680571
DO - https://doi.org/10.1148/radiology.208.2.9680571
M3 - Article
C2 - 9680571
SN - 0033-8419
VL - 208
SP - 423
EP - 430
JO - Radiology
JF - Radiology
IS - 2
ER -