Comparison of 64 Dedector Cranial CT Angiography with Intra-Arterial DSA For Detection of Intracranial Aneurysms

The purpose of our study was to compare findings of 64 detector cranial computed tomographic angiography (CTA) and conventional digital subtraction angiography (DSA) mainly in patients with acute subarachnoid hemorrhage (SAH) headache and diplopia. Between March 2007 and May 2009, 65 consecutive patients were admitted with clinical symptoms and signs of intracranial aneurysm. 44 of 67 detected aneurysms were confirmed during surgery or endovascular embolization. DSA was performed in the 3 days after CTA. CT angiograms and conventional angiographies were studied by two radiologists, who performed aneurysm detection and characterisation of morphological features. Using CTA and DSA, we detected 67 aneurysms in 50 patients. 15 patients did not have any aneurysms in both DSA and CTA. There was no difference between the two modalities in the number of the detected aneurysms. But two aneurysms were falsely located before surgery with CTA. They were located in posterior communicating artery (PcoA) but, had been thought to be located at the internal carotid artery supraclinoid segment at CTA. CTA has an equal sensitivity as DSA in the detection of intracranial aneurysms. It has 100% detection rate in anterior communicating artery and middle cerebral artery bifurcation aneurysms, but aneurysms at some locations, like the ones at PcoA, were hard to detect with CTA. DSA preserves its diagnostic value for detection of posterior circulation aneurysms.