The clinical value of three-dimensional computed tomographic angiography (3D-CTA)in acute subarachnoid hemorrhage from intracranial aneurysms

Objective To investigate the clinical value of 3D-CTA in the diagnosis of aneurysmal subarachnoid hemorrhage.Methods The data of 3D-CTA,DSA and operation in 29 patients with aneurysmal subarachnoid hemorrhage were reviewed retrospectively.The CTA reconstructed images were processed into shaded volume rendering(SVR),maximal intensity projection(MIP),color shaded surface display(SSD),and virtual endoscopy(VE)images.Images of 3D-CTA and DSA were analysed by 2 neurosurgeons,2 neuroradiologists and 2 interventional neuroradiologists.Results Thirty-one aneurysms were detected by 3D-CTA.Aneurysms body and neck,parent artery,and the relationship between the aneurysms and surrounding structures were accurately displayed.Twenty-eight aneurysms were detected by DSA,and another 3 were not detected.The accuracy rate of 3D-CTA in the diagnosis of ruptured aneurysms was 100%,and that of DSA was 90%.Among the 29 patients, 17 underwent operation treatment,and the results of 3D-CTA is useful operation.Maximal diameter of aneurysms body was 19.7 mm and minimal diameter was 1.2 mm.There were no significant differences between the CTA and DSA in the measurement of the aneurysms.Conclusion 3D-CTA is a sensitive,rapid,and noninvasive method for detecting intracranial aneurysms.3D-CTA may by the first choice for diagnosing intracranial aneurysms,especially in an emergency situation.