Performance analysis of 8-channel MDCT angiography in detection, localization, and sizing of intracranial aneurysms identified on DSA.

PURPOSE: To retrospectively analyze the performance of 8-channel multi-detector computed tomographic angiography (MDCTA) in detecting, localizing, and sizing intracranial aneurysms using conventional intraarterial digital subtraction angiography (DSA) as the gold standard. MATERIALS AND METHODS: A retrospective search from November 2004 to August 2006 revealed subarachnoid hemorrhage (SAH) in 25 patients (13 females and 12 males, age range 21-73 years) who underwent both DSA and 8-channel MDCTA exams. Two independent reviewers compared both studies for the presence, location, and size of the aneurysm. RESULTS: A total of 35 aneurysms in 25 patients were identified on DSA, and 33 on MDCTA. MDCTA missed two 4-mm posterior communicating artery (PcoA) aneurysms. There was a mismatch in the location of two aneurysms. One aneurysm at PcoA on DSA was reported as a supraclinoid internal carotid artery (ICA) aneurysm on MDCTA. The other on M2 bifurcation was reported as on M1. No size mismatch was noted. MDCTA had a 94% (33/35) aneurysm detection rate, 88% (31/35) aneurysm localization rate and 100% (33/33) sizing rate. CONCLUSION: MDCTA correlated perfectly with DSA in the detection of intracranial aneurysms of anterior communicating artery and middle cerebral artery; however, slightly lower performance was noted in the PcoA and ICA supraclinoid segment aneurysms.