Comparative Analysis Of Three-dimensional Ct Angiography And Three-dimensional Digital Subtraction Angiography In The Diagnosis And Measurement Of Intracranial Aneurysm

Objective:To analyze the values of 256-slice three-dimensional computerized tomography angiography(3D-CTA) in the diagnosis and the measurement of anatomic parameters of intracranial aneurysms compared with three-dimensional digital subtraction angiography(3D-DSA), as reference standard. Materials and Methods:Fifty-six patients whose clinical manifestations were suspected as intracranial aneurysms treated in the first department of Neurosurgery of the Second Bethune Hospital of Jilin University from December 2013 to December 2015 were analyzed retrospectively. Both head 3D-CTA and 3D-DSA were performed in all the patients. We analyzed the results from the following three aspects:(1) The sensitivity, specificity, positive predictive value and negative predictive value of 3D-CTA in depicting the number of intracranial aneurysms were analyzed, with the number of aneurysms detected by 3D-DSA as the standard. Compare the difference between 3D-CTA and 3D-DSA in the detection of aneurysm.(2) The aneurysms’ maximum diameter and width of neck were measured at the same angle by 3D-CTA VR and 3D-DSA respectively. The measured values of 3D-DSA images were used as the standard to compare the differences of the maximum diameter and the width of neck of aneurysms between the 3D-CTA VR images and the 3D-DSA images.(3) Comparing the difference in the clarity of displaying the aneurysm neck, spatial relationship with parent artery and the perforator vessels between 3D-CTA and 3D-DSA. Results:Among the 56 patients who were suspected to have intracranial aneurysms, 3D-DSA revealed 56 aneurysms in 52 patients and no aneurysm was revealed in 4 patients. The sensitivity, specificity, positive predictive value, negative predictive value of 3D-CTA was 92.9%, 66.7%, 96.3%, 50% in comparison with 3D-DSA in detection of number of aneurysm. The consistency of the number of aneurysms detected between 3D-CTA and 3D-DSA was high, and there was no statistical significance in the detection of intracranial aneur ysm between them. The maximum diameter(`x±s, mm) of aneurysms were 5.51±2.46mm、5.53±2.44 mm, measured by 3D-CTA and 3D-DSA respectively, the statistic significance was not remarkable(P>0.05). The width of neck(`x±s, mm) of aneurysms were 3.86±1.24mm、3.80±1.20 mm, measured by 3D-CTA and 3D-DSA respectively, the statistic significance was remarkable(P <0.05). The statistical significant was remarkable between 3D-CTA and 3D-DSA in the clarity of displaying the aneurysm neck, spatial relationship with parent artery and the perforator vessels(P<0.05). Conclusion:1. The sensitivity and specificity of aneurysm detection with 3D-CTA are high. 3D-CTA can be used as the preferred method for patients with suspected aneurysm.2. The maximum diameter measurement of 3D-CTA is accurate, but the width of neck measurement of 3D-CTA is wider than the real value. 3D-DSA is needed to measure the width of neck accurately.3. The clarity of the aneurysm’s neck, spatial relationship with parent artery and perforator vessels displayed by 3D-CTA is lower than 3D-DSA. 3D-DSA examination should be performed for intracranial aneurysms with complex anatomical structure.