The clinical value of three-dimensional computed tomographic angiography in ruptured intracranial aneurysms at acute phase

Objective To evaluate the value of clinical application of three-dimensional computed tomographic angiography(3D-CTA)in ruptured intracranial aneurysms at acute phase.Methods One hundred and twenty-eight consecutive patients with acute subarachnoid hemorrhage and clinical-highly-suspected ruptured intracranial aneurysms underwent 3D-CTA by GE Lightspeed pro scanner before admission(at 2h～4d after onset).Then conventional digital subtraction angiography(DSA)were performed in 111 patients after 3D-CTA.Six patients were performed DSA before 3D-CTA.All of the source images were processed into volume rendering(VR)and some of them have maximal intensity projection(MIP).Images of 3D-CTA and DSA were reviewed by two independent blinded radiologist.Results A total of 130 aneurysms(diameter 1.1～28mm)were detected by 3D-CTA and DSA in 112 patients.Everyone of ninety seven patients had a single aneurysm;fifteen patients had multiple intracranial aneurysms(MIA),including everyone of twelve patients had two aneurysms and three had three aneurysms.One hundred and twenty-five aneurysms were detected by 3D-CTA in 111 of 112 patients(everyone of ten patients had two aneurysms and two had three aneurysms).DSA demonstrated 122 aneurysms in 104 of 107 patients(everyone of twelve patients had two aneurysms and three had three aneurysms).All patients did not show any new neurological deficits or deteriorating neurological deficits during 3D-CTA examination.One hundred and nine aneurysms of 105 patients were treated by surgery clipping or embolization.Conclusion 3D-CTA was a quick,economic and relative noninvasive method for the diagnosis of intracranial aneurysms,and had very high sensitivity and specificity,which can be used to diagnose ruptured intracranial aneurysms at acute phase instead of DSA.