The clinical value of 3D-CTA in diagnosis and treatment of intracranial aneurysms

Objective To evaluate the clinical value of three-dimensional computerized tomography angiography (3D-CTA) in the diagnosis and treatment of intracranial aneurysms. Methods 52 patients with suspected intracranial aneurysms were examined by 3D-CTA systems. The decision of whether direct surgery or further 3D-DSA examinations was made on the basis of the type and quality of information provided by 3D-CTA. All cases underwent postoperative 3D-DSA. Results 58 intracranial aneurysms were identified in 52 patients. In 6 patients, both 3D-CTA and 3D-DSA were negative for a source of subarachnoid hemorrhage (SAH). The sensitivity, specificity, and negative likelihood ratio of 3D-CTA in the detection of intracranial aneurysms were 94.8%, 100% and 0.0518 respectively, and on a per-aneurysm basis respectively were 97.8%,100% and 0.022. There was an excellent correlation between 3D-CTA, 3D-DSA and surgery in assessing the size and shape of aneurysm. The morphological characteristics and surrounding of the aneurysm was displayed clearly in 3D-CTA. Conclusion 3D-CTA is a quick, reliable and relatively noninvasive method for diagnosing intracranial aneurysms. It delineates detailed aneurismal morphology, and provides useful information in planning microsurgical approaches.