• He Zhang, Chang Hou, Zhi Zhou, Hao Zhang, Gen Zhou, and Gui Zhang.
• Department of Radiology, Shanghai First People's Hospital, Medical College, Shanghai Jiao Tong University, Shanghai, China.
• J Neuroimaging. 2014 Mar 1;24(2):137-43.

Background And PurposeThe diagnostic performance of 64-detector computed tomographic angiography (CTA) for detection of small intracranial aneurysms (SIAs) was evaluated.MethodsIn this prospective study, 112 consecutive patients underwent 64-detector CTA before volume-rendering rotation digital subtraction angiography (VR-RDSA) or surgery. VR-RDSA or intraoperative findings or both were used as the gold standards. The accuracy, sensitivity, specificity, and positive predictive values (PPV) and negative predictive values (NPV), as measures to detect or rule out SIAs, were determined by patient-based and aneurysm size-based evaluations.ResultsThe reference standard methods revealed 84 small aneurysms in 71 patients. The results of patient-based 64-detector CTA evaluation for SIAs were: accuracy, 98.2%; sensitivity, 98.6%; specificity, 97.6%; PPV, 98.6%; and NPV, 97.6%. The aneurysm-based evaluation results were: accuracy, 96.8%; sensitivity, 97.6%; specificity, 95.1%; PPV, 97.6%; and NPV, 95.1%. Two false-positive and two false-negative findings for aneurysms <3 mm in size occurred in the 64-detector CTA analysis.ConclusionThe diagnostic performance of 64-detector CTA did not improve much compared with 16-detector CTA for detecting SIAs, especially for very small aneurysms. VR-RDSA is still necessary for patients with a history of subarachnoid hemorrhage if the CTA findings are negative.Copyright © 2012 by the American Society of Neuroimaging.

29 keywords...

hide…