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July2010 Vol.47 Issue:        3       (Supp.) Table of Contents
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The Diagnostic Accuracy of 64-Row Multislice Computerized Tomography Angiography in Detection of Intracranial Aneurysms

Amr K. Elsamman1, Lamiaa I.A. Metwally2, Ahmed M. Abdelalim3


Departments of Neurosurgery1, Radiodiagnosis2, Neurology3, Cairo University; Egypt



Background: Accurate localization of intracranial aneurysms is crucial for determining the appropriate treatment. Objective: To emphasize on the accuracy of evaluation of intracranial aneurysms using CT angiography (CTA) technique. Methods: Twenty two patients with intracranial aneurysms were included in this study. They were evaluated clinically and radiologically using multislice CT angiography of the brain. Digital subtraction angiography was performed for 6 patients. Surgical clipping was performed for treatment. Results: Twenty four aneurysms were found in 22 patients with subarachnoid hemorrhage: 23 were clipped surgically. The site of aneurysms included: 11 anterior communicating artery, 8 middle cerebral artery, 2 posterior communicating artery, 1 posterior cerebral artery, and 1 carotid bifurcation aneurysms. The sensitivity and positive predictive value of detection of aneurysms >3mm was 100% compared to surgical findings. One aneurysm, 2.7mm in diameter, was suspicious on CTA and was confirmed by digital subtraction angiography. The surgical clipping was based on CTA alone in 16 patients (72.7%). Conclusion: CTA is a sensitive non-invasive tool for detection of intracranial aneurysms that would improve selection of management yet it cannot completely replace conventional angiography as its sensitivity is lower in aneurysms <3mm and it lacks dynamic information. Both modalities should be used complementary to each other. [Egypt J Neurol Psychiat Neurosurg.  2010; 47(3): 425-431]


Key Words: CT angiography, intracranial aneurysms, subarachnoid hemorrhage.


Correspondence to Amr K. Elsamman, Department of Neurosurgery, Cairo University, Egypt.

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