Multidetector CTA ups diagnostic ante for brain aneurysms
Multidetector CT angiography will soon replace catheter angiography as the diagnostic gold standard for patients with intracranial aneurysms, according to Swiss researchers.
Investigators from University Hospital in Lausanne compared four-row CTA with intra-arterial digital subtraction angiography in 50 consecutive patients with suspected brain aneurysms. They found that CTA was an accurate screening test.
Their findings exceeded those of the single-slice CTA literature, especially for aneurysms smaller than 3 mm. The researchers published their results in the April issue of the Journal of Neurosurgery.
They found a statistically significant (p<0.001) correlation between multidetector CTA and DSA for aneurysm size assessment. On a per-aneurysm basis, multidetector CTA reported the following: · sensitivity, 94.8% · specificity, 95.2% · accuracy for aneurysm detection, 94.9%
DSA is still performed for endovascular treatment in some positive cases. CTA, however, would void the need to perform DSA in all patients with a high degree of suspicion, said principal investigator Dr. Max Wintermark of University Hospital?s diagnostic and interventional radiology department. In patients with ruptured aneurysms in need of immediate surgery, CTA could help neurosurgeons quickly plan intervention.
Introduction of eight- and 16-row multidetector CTA should consolidate CT?s place in the field, according to Wintermark. With more detectors, CTA will provide even higher spatial resolution and better distinction between arteries and veins.
?With future CT scanners using flat-panel detectors, you might expect CTA to replace diagnostic DSA completely,? he said. ?Only those patients eligible for endovascular therapy will undergo DSA.?
