The Value Of Detection Of Intracranial Aneurysms With Multislice Helical Computerized Tomography Angiography-A Meta Analysis

Objectives: As an invasive technique, digital subtraction angiography (DSA) is still the gold standard in making a diagnosis of intracranial aneurysm. Many studies have been done to investigate the usefulness of computed tomography angiography (CTA) for the diagnosis of intracranial aneurysms and discuss the possibility of using CTA as the primary non-invasive imaging method. So we performed a meta-analysis to determine the usefulness and accuracy of CTA for the diagnosis of intracranial aneurysms.Methods: A comprehensive and systematic search was conducted in MEDLINE,EMBASE,CBM and CJFD databases. After a systematic review of the studies, sensitivity, specificity and other measures of accuracy of CTA in the diagnosis of intracranial aneurysms were summarized. Summary receiver operating characteristic curves were used to summarize overall test performance.Results: At last 10 studies were included. The summary estimates for CTA in the diagnosis of intracranial aneurysms in the studies included were as follows: 1.For aneurysms number as true positive, sensitivity, 0.957 (95%confidence interval [CI], 0.940 to 0.971 ), specificity, 0.970(95% CI, 0.941 to 0.987), AUC98.99%; 2. For patients number as true positive, sensitivity, 0.979 (95% [CI], 0.965 to 0.989), specificity, 0.980(95% CI, 0.954to 0.993), AUC99.20%.Conclusions: CTA is a sensitive and specific test and appears equivalent to that of DSA for detection and evaluation of intracranial aneurysms. Using CTA as the primary imaging method appears to be practical and safe. CTA is very useful in the decision process whether to clip or coil an aneurysm.