Detection of intracranial aneurysms with two-dimensional and three-dimensional multislice helical computed tomographic angiography

Neurosurgery. 2004 Feb;54(2):336-40; discussion 340-1. doi: 10.1227/01.neu.0000103448.07132.e1.


Objective: Computed tomographic angiography (CTA) has become a diagnostic method for the detection of intracranial aneurysms in cases of subarachnoid bleeding. We sought to evaluate the detection of aneurysms with CTA with a novel multislice helical computed tomographic scanner.

Methods: Prospectively, 179 patients underwent multislice CTA, followed by digital subtraction angiography (DSA) of both carotid arteries with or without the posterior circulation, DSA of one carotid artery with or without the posterior circulation, or DSA of the posterior circulation alone. The total number of carotid arteries studied was 298, and the number of vertebrobasilar arteries studied was 124.

Results: Of 178 aneurysms verified with DSA or intraoperatively, CTA failed to detect 7 aneurysms of 1 to 2 mm and 1 partially thrombosed, 4-mm aneurysm. The sensitivity and specificity of CTA for aneurysm detection were 0.96 and 0.97, respectively.

Conclusion: The first generation of multislice computed tomographic technology does not improve CTA to surpass DSA for the detection of small aneurysms of 1 to 2 mm. In practice, however, CTA is superior as a fast noninvasive method without complications.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Angiography, Digital Subtraction*
  • Cerebral Angiography / instrumentation*
  • Diagnostic Errors
  • Humans
  • Imaging, Three-Dimensional / instrumentation*
  • Intracranial Aneurysm / diagnostic imaging*
  • Middle Aged
  • Prospective Studies
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Tomography, Spiral Computed / instrumentation*