2004•Chinese Journal of Cenebrovascular DiseasesRequires access
The value of computerized tomography angiography and magnetic resonance angiography in the detection and treatment of intracranial aneurysms
Weidong Yu
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Abstract
Objective To evaluate the application of computerized tomography angiography (CTA) and magnetic resonance angiography (MRA) in the detection and treatment of intracranial aneurysms. Methods 302 patients with intracranial aneurysms and 18 non-intracranial aneurysms patients with spontaneous subarachnoid hemorrhage (SAH) were examined by CTA, MRA and/or digital subtraction angiography (DSA) from March 1994 to June 2004. In 302 intracranial aneurysms, 91 cases were classified as Hunt Hess Grade Ⅰ, 156 as Grade Ⅱ, 40 as Grade Ⅲ, 11 as Grade Ⅳ, and 4 as Grade Ⅴ. The aneurysms were confirmed by surgery and the results were analyses retrospectively. Results 203 aneurysms were detected only by CTA and 88 aneurysms by DSA only respectively and confirmed by surgery. Of the 12 aneurysms detected only by MRA, 10 aneurysms were confirmed by surgery, a right middle cerebral artery aneurysm detected by MRI was confirmed a a right internal carotid artery aneurysm intraoperatively, and a giant anterior communicating artery aneurysm which was not revealed by MRA was confirmed by surgery. 10 aneurysms were highly suspected by CTA, then detected by DSA and confirmed in operation finally, and an aneurysm which was not revealed by DSA was detected by CTA and confirmed by surgery. 4 aneurysms were suspected by MRA, then detected by CTA and confirmed in operation finally. The angiography of 18 patients with spontaneous subarachnoid hemorrhage did not reveal positive findings. The results demonstrated that the sensitivity of detecting aneurysms on CTA was 100%, that on MRA was 87.5%, that on DSA was 98.9%, and specificity of finding aneurysms on CTA was 100%. Conclusion CTA can be used as the first choice in detect-ing intracranial aneurysms. The reliability for detecting intracranial aneurysms on CTA is superior to that on MRA or DSA. MRA may be used as an alternative method for detecting intracranial aneurysms, but its reliability is lower than CTA and DSA