Accuracy of 16-row multislice computerized tomography angiography for assessment of intracranial aneurysms

Sixteen-row multislice CT has great potential for use in vascular studies. The aim of the study was to assess the diagnostic accuracy of 16-row multislice CTA in detecting intracranial aneurysms compared with 2D-DSA and surgical findings.

One hundred fifty-two consecutive patients were included in the study and successively underwent 16-slice CTA, 2D-DSA, and surgery in some patients. This was performed with a 16-row multislice CT machine, detector slice of 0.75 mm, reconstruction interval of 0.40 mm, and timing determined by bolus trigger. The 16-slice CTA and 2D-DSA results were evaluated independently by 3 different neuroradiologists who performed aneurysm detection using MIP, SSD, and VRT.

With the combination of 16-slice CTA, 2D-DSA, and intraoperative findings, 92 aneurysms were detected in 86 of the 152 patients. Two aneurysms were missed when 16-slice CTA was used. Three aneurysms were not clearly depicted at 2D-DSA, but proven at surgery. There was no statistically significant difference in sensitivity between 16-slice CTA and 2D-DSA (P = 1.0). The sensitivity of 16-slice CTA for detecting aneurysms <4 mm, between 4 and 10 mm, and >10 mm was 96% (95% CI: 79.6%-99.9%), 98.1% (95% CI: 89.7%-100%), and 100% (95% CI: 78.2%-100%), respectively, on a per-aneurysm basis. The sensitivity, specificity, and accuracy of 16-slice CTA for detecting aneurysms were 97.8% (95% CI: 92.4%-99.7%), 100% (95% CI: 94.6%-100%), and 98.7% (95% CI: 95.5%-99.8%), respectively, on a per-aneurysm basis.

Sixteen-slice CTA shows promising diagnostic accuracy that appears to be comparable with 2D-DSA for the detection of suspected intracranial aneurysms, and 16-slice CTA is sensitive enough to replace 2D-DSA in detecting aneurysms.