Diagnostic Accuracy of Multi- Slice Computed Tomographic Angiography in Detecting Intracerebral Aneurysms: A Comparison with Digital Subtraction Angiographyas the Gold Standard
Sarah Nisar, Kamran Naseem, Fariha Mumtaz
Keywords: Cerebral aneurysm, non-invasive, imaging modality, sensitivity
ABSTRACT
Introduction: Computed tomography (CT) is the earliest method for evaluating patients with suspicion of intracerebral aneurysms. Rapid evaluation of ICA by technically advanced and minimally invasive cross- sectional imaging, such as multi-detector computed tomography angiography (CTA) and magnetic resonance angiography (MRA), has changed the diagnostic approach to ICA evaluation.
Objective: To determine the diagnostic accuracy of multi-slice CT angiography in detecting intracerebral aneurysms using Digital Subtraction Angiography (DSA) as the gold standard.
Methods: A total of 113 patients with clinical symptoms and signs suggestive of harbouring an intracranial aneurysm and aged 20-60 years of either gender were included in the study. Patients with a history of brain surgery and traumatic subarachnoid haemorrhage were excluded. All the patients then underwent multi-slice computed tomography angiography examinations. After CTA, DSA was performed in every patient, and findings were correlated.
Results: Mean age was 50.82 ± 6.77 years. Out of these 113 patients, 44 (38.94%) were male and 69 (61.06%) were female, with a male to female ratio of 1:1.6. CTA supported the diagnosis of intra-cerebral aneurysm in 70 (61.95%) patients, out of which 64 (True Positive) had intra-cerebral aneurysm and 06 (False Positive) had no intra-cerebral aneurysm on DSA. Among 43 CTA negative patients, 04 were False negatives and 39 were True negatives. Overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of multi-slice computed tomographic angiography (CTA) in detecting intracerebral aneurysms were 94.12%, 86.67%, 91.43%, 90.70%, and 91.15%, respectively.
Conclusion: This study concluded that multi-slice CT angiography is a highly sensitive and accurate non- invasive modality for detecting intra-cerebral aneurysms and has not only dramatically improved our ability to detect intra-cerebral aneurysms but also improved patient care by proper surgical planning pre-operatively, which consequently reduces complications.
Keywords: Cerebral aneurysm, non-invasive, imaging modality, sensitivity