Value of Computed Tomographic Angiography in the Detection and Preoperative Planning of Intracranial Aneurysms

We aimed to determine 1) the value of computed tomographic angiography in the detection of intracranial aneurysms compared with surgery and 2) the role of computed tomographic angiography in preoperative planning of intracranial aneurysms by comparing computed tomographic angiography findings with surgical observations regarding size and shape of the aneurysm, size of the neck and orientation of the dome. Fifty patients suspected to harbour intracranial aneurysms underwent computed tomographic angiography and surgery. Computed tomographic angiography and surgery findings were compared in terms of presence of and surgically important features required in preoperative planning. The sensitivity of computed tomographic angiography in the detection of aneurysms when compared with surgery was 96%. Out of the 50 aneurysms identified by computed tomographic angiography, computed tomographic angiography findings and surgical observations were in full agreement regarding the location and shape of the aneurysms (kappa = 1.0). The agreement was slightly less in depicting the size of the neck (kappa = 0.967), size of the aneurysm and orientation of the dome (kappa = 0.95). Although digital subtracted angiography is the standard method in the diagnosis of intracranial aneurysms, computed tomographic angiography has proved to be of great value in the management of presumed aneurysm patients. Computed tomographic angiography achieves a high sensitivity rate in detecting aneurysms and provides excellent anatomical information required for pretreatment planning.