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Diagnosing cerebral aneurysms by computed tomographic angiography: meta-analysis.

Jan Menke¹, Jörg Larsen, Kai Kallenberg

¹Department of Diagnostic Radiology, University Hospital, Goettingen, Germany. Menke-J@T-Online.de

Annals of Neurology

|March 11, 2011

Summary

This summary is machine-generated.

Computed tomographic (CT) angiography accurately diagnoses cerebral aneurysms, especially with modern multidetector CT. This noninvasive imaging may replace digital subtraction angiography (DSA) for suspected intracranial aneurysms.

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Area of Science:

Neurology
Radiology
Medical Imaging

Background:

Cerebral aneurysms pose significant risks, including rupture leading to subarachnoid hemorrhage (SAH), causing substantial morbidity and mortality.
Accurate and timely diagnosis of intracranial aneurysms is crucial for effective patient management and improved outcomes.

Purpose of the Study:

To conduct a meta-analysis evaluating the diagnostic accuracy of noninvasive computed tomographic (CT) angiography for intracranial aneurysms in symptomatic patients.
To compare the performance of CT angiography with digital subtraction angiography (DSA) and intraoperative findings.

Main Methods:

A systematic literature search of four databases, including PubMed, was performed from January 1995 to February 2010.
Forty-five studies comparing CT angiography with DSA and/or intraoperative findings were selected and analyzed.
Data were extracted to construct 2x2 contingency tables on a per-patient and per-aneurysm basis.

Main Results:

The meta-analysis included 3,643 patients, with 86% having SAH and 77% diagnosed with cerebral aneurysms.
Pooled per-patient sensitivity for CT angiography was 97.2% and specificity was 97.9%.
Per-aneurysm pooled sensitivity was 95.0% and specificity was 96.2%. Diagnostic accuracy was higher with multidetector CT, particularly for small aneurysms (≤ 4 mm).

Conclusions:

CT angiography demonstrates high accuracy in diagnosing cerebral aneurysms, especially when utilizing modern multidetector CT technology.
CT angiography is poised to increasingly supplement or potentially replace DSA in the diagnostic workup of suspected cerebral aneurysms.