Can sufficient preoperative information of intracranial aneurysms be obtained by using 320-row detector CT angiography alone?

Jpn J Radiol. 2013 Sep;31(9):600-7. doi: 10.1007/s11604-013-0228-2. Epub 2013 Jun 16.

Abstract

Purpose: To determine whether sufficient pre-surgical treatment information of unruptured intracranial aneurysms can be obtained by using 320-row detector CT angiography (CTA) alone.

Materials and methods: We enrolled 40 consecutive patients with unruptured intracranial aneurysms. All patients were prospectively conducted to perform 320-detector CTA as the only preoperative modality. Two blinded readers independently assessed CTA images. Interobserver agreement and the agreement between CTA and surgical findings were determined by calculating the κ coefficient. The referring neurosurgeons judged the usefulness of the information provided by CTA for treatment decisions.

Results: All patients had surgery without intraarterial digital subtraction angiography. Agreement between CTA and surgical findings was excellent for the aneurysm location (κ = 1.0) and good for the shape (κ = 0.71), neck (κ = 0.74) and its relationship with adjacent branches (κ = 0.71). Information obtained with 320-detector CTA was highly useful for surgical treatment in 37 of 40 (93 %) patients, although small perforators deriving from the aneurysm in 2 cases were not fully visualized on CTA images.

Conclusion: In most patients with unruptured intracranial aneurysms, sufficient pre-surgical treatment information can be obtained by using 320-detector CTA alone.

MeSH terms

  • Adult
  • Aged
  • Cerebral Angiography / methods*
  • Contrast Media
  • Female
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Intracranial Aneurysm / diagnostic imaging*
  • Intracranial Aneurysm / surgery
  • Iopamidol
  • Male
  • Middle Aged
  • Observer Variation
  • Preoperative Care / methods*
  • Prospective Studies
  • Radiographic Image Enhancement / methods
  • Reproducibility of Results
  • Tomography, X-Ray Computed / methods*

Substances

  • Contrast Media
  • Iopamidol