Preliminary experience of three-dimensional computed tomographic angiography in the diagnosis and preoperative evaluation of intracranial aneurysms

Objective To assess the role of 3D-CTA in the diagnosis and preoperative evaluation of intracranial aneurysms.Methods 37 cases of suspected intracranial aneurysms were studied with both 3D-CTA and digital subtraction angiography(DSA).26 patients of them underwent operation.The reconstructed images were processed into shaded volume rendering (SVR) and maximal intensity projection(MIP) and color shaded surface display(SSD) and virtual endoscopy images.Images of 3D-CTA and DSA were analysed by 2 neurosurgeons,2 neuroradiologists and 2 interventional neuroradiologists.Results 39 aneurysms were detected by 3D-CTA.Aneurysms body,neck,parent artery and the relationship between the aneurysms and surrounding structures were clearly and surely displayed.35 aneurysms were detected by DSA,another 4 were not detected.100% accuracy for 3D-CTA in the diagnosis of ruptured aneurysms and 89% accuracy in the identification of DSA.26 patients underwent operation,and the results of 3D-CTA corresponded very well to those of operation.Maximal diameter of aneurysm body was 19.7 mm and minimal diameter was 1.2 mm.There was no significant difference between the CTA and DSA of the diameter and the detection rate of the aneurysms.Conclusion 3D-CTA is a sensitive,rapid and noninvasive method for detecting intracranial aneurysms.We suggested that 3D-CTA may be the first choice for diagnosing intracranial aneurysms,especially in an emergent situation.It is important to raise the rate of aneurysm detection about the data acquisition and analysis method of CTA.