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Three dimensional CT angiography versus digital subtraction angiography in the detection of intracranial aneurysms in subarachnoid hemorrhage.
J Neurointerv Surg. 2010 Dec; 2(4):385-9.JN

Abstract

INTRODUCTION

Ruptured intracranial aneurysms are responsible for over 90% of cases of spontaneous subarachnoid hemorrhage (SAH). Conventional digital subtraction angiography (DSA) remains the gold standard for diagnosing the source of SAH. A prospective study is presented wherein SAH patients underwent three dimensional CT angiography (CTA) prior to DSA in order to assess the specificity and sensitivity of this non-invasive modality to detect aneurysms.

METHODS

179 consecutive patients with spontaneous SAH presented over 36 months, as identified by screening CT and CTA. Patients with negative CTA findings underwent DSA within 24 h of presentation. All patients who were determined to have angiographically negative SAH underwent follow-up DSA 2 weeks later.

RESULTS

Of the 179 patients screened by CTA, 13 (7%) were negative for aneurysms or other vascular lesions (arteriovenous malformation or dural fistula) on CTA and underwent DSA. No new lesions were identified on six vessel angiography, resulting in a 0% false negative rate (sensitivity 100%, predictive value 100%). MRI to rule out thrombosed aneurysms and repeat angiography at the 2 week follow-up were negative.

CONCLUSIONS

Sensitivity and specificity were higher than previously reported, suggesting that CTA may be used as an initial screening tool in lieu of DSA. Further studies are necessary to determine if CTA can supplant DSA in ruling out all forms of vascular disease in idiopathic SAH.

Authors+Show Affiliations

Department of Neurological Surgery, UMDNJ, Newark, New Jersey 07101, USA. c.prestigiacomo@umdnj.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

21990653

Citation

Prestigiacomo, Charles J., et al. "Three Dimensional CT Angiography Versus Digital Subtraction Angiography in the Detection of Intracranial Aneurysms in Subarachnoid Hemorrhage." Journal of Neurointerventional Surgery, vol. 2, no. 4, 2010, pp. 385-9.
Prestigiacomo CJ, Sabit A, He W, et al. Three dimensional CT angiography versus digital subtraction angiography in the detection of intracranial aneurysms in subarachnoid hemorrhage. J Neurointerv Surg. 2010;2(4):385-9.
Prestigiacomo, C. J., Sabit, A., He, W., Jethwa, P., Gandhi, C., & Russin, J. (2010). Three dimensional CT angiography versus digital subtraction angiography in the detection of intracranial aneurysms in subarachnoid hemorrhage. Journal of Neurointerventional Surgery, 2(4), 385-9. https://doi.org/10.1136/jnis.2010.002246
Prestigiacomo CJ, et al. Three Dimensional CT Angiography Versus Digital Subtraction Angiography in the Detection of Intracranial Aneurysms in Subarachnoid Hemorrhage. J Neurointerv Surg. 2010;2(4):385-9. PubMed PMID: 21990653.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Three dimensional CT angiography versus digital subtraction angiography in the detection of intracranial aneurysms in subarachnoid hemorrhage. AU - Prestigiacomo,Charles J, AU - Sabit,Aria, AU - He,Wenzhuan, AU - Jethwa,Pinakin, AU - Gandhi,Chirag, AU - Russin,Jonathan, Y1 - 2010/06/24/ PY - 2011/10/13/entrez PY - 2011/10/13/pubmed PY - 2012/3/10/medline SP - 385 EP - 9 JF - Journal of neurointerventional surgery JO - J Neurointerv Surg VL - 2 IS - 4 N2 - INTRODUCTION: Ruptured intracranial aneurysms are responsible for over 90% of cases of spontaneous subarachnoid hemorrhage (SAH). Conventional digital subtraction angiography (DSA) remains the gold standard for diagnosing the source of SAH. A prospective study is presented wherein SAH patients underwent three dimensional CT angiography (CTA) prior to DSA in order to assess the specificity and sensitivity of this non-invasive modality to detect aneurysms. METHODS: 179 consecutive patients with spontaneous SAH presented over 36 months, as identified by screening CT and CTA. Patients with negative CTA findings underwent DSA within 24 h of presentation. All patients who were determined to have angiographically negative SAH underwent follow-up DSA 2 weeks later. RESULTS: Of the 179 patients screened by CTA, 13 (7%) were negative for aneurysms or other vascular lesions (arteriovenous malformation or dural fistula) on CTA and underwent DSA. No new lesions were identified on six vessel angiography, resulting in a 0% false negative rate (sensitivity 100%, predictive value 100%). MRI to rule out thrombosed aneurysms and repeat angiography at the 2 week follow-up were negative. CONCLUSIONS: Sensitivity and specificity were higher than previously reported, suggesting that CTA may be used as an initial screening tool in lieu of DSA. Further studies are necessary to determine if CTA can supplant DSA in ruling out all forms of vascular disease in idiopathic SAH. SN - 1759-8486 UR - https://www.unboundmedicine.com/medline/citation/21990653/Three_dimensional_CT_angiography_versus_digital_subtraction_angiography_in_the_detection_of_intracranial_aneurysms_in_subarachnoid_hemorrhage_ L2 - https://jnis.bmj.com/cgi/pmidlookup?view=long&pmid=21990653 DB - PRIME DP - Unbound Medicine ER -