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Published on: January 18, 2018
Multidetector row CT angiography in spontaneous lobar intracerebral hemorrhage: a prospective comparison with
D Y Yoon1, S K Chang, C S Choi
1Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Kangdong-Gu, Seoul, Korea. evee0914@chollian.net
Insights
Multidetector row CT angiography (MDCTA) accurately detects vascular abnormalities in patients with lobar intracerebral hemorrhage (ICH). This imaging technique shows high sensitivity and specificity, making it reliable for diagnosing the causes of ICH.
Area of Science:
- Neuroradiology
- Vascular Imaging
- Neurology
Background:
- Spontaneous lobar intracerebral hemorrhage (ICH) can be caused by underlying vascular abnormalities.
- Accurate detection of these abnormalities is crucial for patient management.
Purpose of the Study:
- To evaluate the diagnostic accuracy of multidetector row CT angiography (MDCTA) in identifying vascular causes of lobar ICH.
- To compare MDCTA performance against digital subtraction angiography (DSA).
Main Methods:
- Prospective study of 78 patients with lobar ICH who underwent both MDCTA and DSA.
- Independent blinded neuroradiologists assessed CT angiograms, including multiplanar reformations and volume-rendered images.
- Consensus decisions were made to identify vascular abnormalities.
Main Results:
- Twenty-two of 78 patients (28.2%) had detectable vascular abnormalities (aneurysms, arteriovenous malformations, Moyamoya disease).
- MDCTA successfully identified abnormalities in 21 out of 22 patients.
- MDCTA demonstrated high diagnostic performance: 95.5% sensitivity, 100% specificity, and 98.7% accuracy.
Conclusions:
- MDCTA is a highly accurate and reliable imaging modality for diagnosing vascular abnormalities in patients with spontaneous lobar ICH.
- MDCTA offers excellent diagnostic performance, aiding in the etiological diagnosis of ICH.
Background And Purpose:
The aim of our study was to assess the accuracy of multidetector row CT angiography (MDCTA) in the detection of the underlying vascular abnormalities causing spontaneous lobar intracerebral hemorrhage (ICH) compared with conventional digital subtraction angiography (DSA).
Materials And Methods:
Seventy-eight patients who underwent MDCTA with use of a 16-detector row scanner and DSA were prospectively included in this study. Each study was assessed by 2 independent blinded neuroradiologists; decisions were made in consensus. Findings on CT angiograms, including the original axial data, multiplanar reformations, and volume-rendered images with and without automated bone segmentation, were used to identify the underlying causes of ICH.
Results:
Twenty-two of the 78 patients (28.2%) exhibited angiographic abnormalities, including aneurysms of the proximal arteries (n = 9), arteriovenous malformations (n = 7), Moyamoya disease (n = 4), and aneurysms of the distal arteries (n = 2). MDCTA detected the underlying vascular abnormalities in 21 patients except 1 case of small arteriovenous malformation. Overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of MDCTA for detection of underlying vascular abnormalities were 95.5%, 100%, 100%, 98.2%, and 98.7%, respectively.
Conclusions:
MDCTA is a highly accurate imaging technique in the diagnosis of underlying vascular abnormalities in patients with spontaneous lobar ICH.
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