Three dimensional CT angiography versus digital subtraction angiography in the detection of intracranial aneurysms in subarachnoid hemorrhage

Prestigiacomo, Charles J.; Sabit, Aria; He, Wenzhuan; Jethwa, Pinakin R.; Gandhi, Chirag D.; Russin, Jonathan J.

doi:10.1136/jnis.2010.002246

Cited by 42 publications

(26 citation statements)

References 32 publications

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“…In the present work, women at their sixth decade of life consisted most of the patients as in some other studies [9,11,25,30]. The majority of studies have reported a female-to-male ratio of about 1.09-1.42 [23,31,32]. Some experts proposed the role of female hormones in female preference for non-traumatic intracranial hemorrhage but there is a controversy about this [33,34].…”

Section: Discussionmentioning

confidence: 48%

Cerebral Angiographic Findings in Non-Traumatic Intracranial Hemorrhage: A Single Center Experience in the West of Iran

Gharib-Salehi

Alimohammadi

Bagheri

et al. 2017

IrJNS

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Background and Aim:This study aimed at analyzing the demographic characteristics of the patients with non-traumatic intracranial hemorrhage, their angiographic results and the correlation between computed tomography (CT) scan and angiography findings. Methods and Materials/Patients:In a descriptive study, we retrospectively reviewed the records of the patients with non-traumatic intracranial hemorrhage based on their brain CT or lumbar puncture findings from 2011 to 2017. For all patients, four vessel catheter angiography via the femoral approach was performed in the Medical Imaging Center of Kermanshah University of Medical Sciences, Iran. Results:We investigated 143 cases with non-traumatic intracranial hemorrhage which was indicated in CT findings (91.61%) or lumbar puncture (8.39%). Of 143 patients, 64 (44.8%) were men and 79 (55.2%) women (mean age 53.7±12.1 years old). Moreover, 104(72.7%) patients had Subarachnoid Hemorrhage (SAH), 19(13.3%) of them had Intracranial Hemorrhage (ICH), 8(5.6%) ones had Intraventricular Hemorrhage (IVH) and 12(8.4%) patients had normal brain CT. There were 100 cases of aneurysm (69.93%), 13 cases of Arteriovenous Malformations (AVM) (9.09%), 28 cases with negative angiograms (19.58%), and 2 cases with other pathologies (1.4%). Seven (4.89%) cases of multiple aneurysms were also recorded. Of 13 patients with AVM, 8(61.5%) patients had AVM in parieto-occipital region, 2(15.4%) in temporal, 1(7.7%) in frontal region and 2(15.4%) had deep AVM. Two (1.4%) patients with SAH had dural AVF. Twenty-eight (19.6%) patients had negative angiogram, 22 cases of them had second angiography after one to two weeks. The most common positive finding in the second angiogram was Acom aneurysm (18.18%). Conclusion:Aneurysms and AVMs are the most common causes of non-traumatic intracranial hemorrhage. The most common site of intracranial aneurysms is the circle of Willis. A second angiogram after one to two weeks is necessary in most patients with negative results in first angiography after non-traumatic intracranial hemorrhage.

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Section: Discussionmentioning

confidence: 48%

Cerebral Angiographic Findings in Non-Traumatic Intracranial Hemorrhage: A Single Center Experience in the West of Iran

Gharib-Salehi

Alimohammadi

Bagheri

et al. 2017

IrJNS

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“…1b) [20]. Studies with recent technology have shown more promising results, with up to 99.6 % sensitivity on 16-slice CT scanners [21]. Xing et al [17] demonstrated an even higher sensitivity for small aneurysms on a 64-slice CT scanner than conventional nonrotational digital subtraction angiography; however, Wang et al [22] demonstrated an 81.8 % sensitivity for aneurysms smaller than 3 mm when performed on a 320-slice CT.…”

Section: Detection Of Cerebral Aneurysmmentioning

confidence: 99%

Imaging of cerebral aneurysms: a clinical perspective

et al. 2016

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Neuroimaging is a critical element in evaluating and treating patients with cerebral aneurysms. Each neuroimaging technique has unique strengths, weaknesses, and current developments. In this review, we discuss the utility of two primary noninvasive radiological techniques-computed tomography angiography (CTA) and magnetic resonance angiography (MRA)-as well as of digital subtraction angiography (DSA) for evaluation of cerebral aneurysms. These techniques allow comprehensive evaluation of aneurysm size, location, rupture status, and other imaging characteristics that guide clinicians to make appropriate and timely treatment recommendations.

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“…1), 8 of which met the inclusion criteria. 1,2,5,7,13,15,16,23 Results for these studies are summarized in Table 1. Three hundred sixty-eight patients, including those from the Groningen series, were eligible for the pooled analysis.…”

Section: Pooled Analysismentioning

confidence: 99%

Repeat digital subtraction angiography after a negative baseline assessment in nonperimesencephalic subarachnoid hemorrhage: a pooled data meta-analysis

Bakker¹,

Groen²,

Foumani³

et al. 2014

JNS

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Object A repeat digital subtraction angiography (DSA) study of the cranial vasculature is routinely performed in patients with diffuse nonperimesencephalic subarachnoid hemorrhage (SAH) after negative baseline CT angiography (CTA) and DSA studies. However, DSA carries a low but substantial risk of neurological complications. Therefore, the authors evaluated the added value of repeat DSA in patients with initial angiographically negative diffuse nonperimesencephalic SAH. Methods A systematic review of the contemporary literature was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Studies from January 2000 onward were reviewed since imaging modalities have much improved over the last decade. A pooled analysis was conducted to identify the detection rate of repeat DSA. In addition, the diagnostic yield of repeat DSAs in a prospectively maintained single-center series of 1051 consecutive patients with SAH was added to the analysis. Results An initial search of the literature yielded 179 studies, 8 of which met the selection criteria. Another 45 patients from the authors' institution were included in the study, providing 368 patients eligible for the pooled analysis. In 37 patients (10.0%, 95% CI 7.4%–13.6%) an aneurysm was detected on repeat DSA. The timing of the repeat DSA varied from 1 to 6 weeks after the initial DSA. The use of 3D techniques was poorly described among these studies, and no direct comparisons between CTA and DSA were made. Conclusions Repeat DSA is still warranted in patients with a diffuse nonperimesencephalic SAH and negative initial assessment. However, the exact timing of the repeat DSA is subject to debate.

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Three dimensional CT angiography versus digital subtraction angiography in the detection of intracranial aneurysms in subarachnoid hemorrhage

Abstract: Sensitivity and specificity were higher than previously reported, suggesting that CTA may be used as an initial screening tool in lieu of DSA. Further studies are necessary to determine if CTA can supplant DSA in ruling out all forms of vascular disease in idiopathic SAH.

Cited by 42 publications

References 32 publications

Cerebral Angiographic Findings in Non-Traumatic Intracranial Hemorrhage: A Single Center Experience in the West of Iran

Cerebral Angiographic Findings in Non-Traumatic Intracranial Hemorrhage: A Single Center Experience in the West of Iran

Imaging of cerebral aneurysms: a clinical perspective

Repeat digital subtraction angiography after a negative baseline assessment in nonperimesencephalic subarachnoid hemorrhage: a pooled data meta-analysis

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