Detection of cerebral aneurysms in nontraumatic subarachnoid haemorrhage: role of multislice CT angiography in 130 consecutive patients

Abstract

Purpose.

The leading cause of a nontraumatic subarachnoid haemorrhage is rupture of an intracranial aneurysm. The aim of this study was to assess the usefulness of multislice computed tomography angiography (CTA) in identifying and evaluating cerebral aneurysms by comparing it with intra-arterial digital subtraction angiography (DSA) and intraoperative findings.

Materials and methods.

During a 20-month period (June 2004 and February 2006), 130 patients with a CT diagnosis of nontraumatic acute subarachnoid haemorrhage were prospectively recruited to this study and underwent 16-detector CTA and DSA (57 men, 73 women; mean age 59.5 years). Twenty-five patients who underwent DSA alone postclipping were excluded. CTA and DSA were evaluated by the performing radiologist to assess the presence of one or more aneurysms and their morphological characteristics.

Results.

CTA detected 133 aneurysms, whereas DSA identified 134: the aneurysm missed by CTA was 2 mm in size.

Conclusions.

CTA is fast and relatively noninvasive, and its sensitivity appears similar to that of DSA in detecting and evaluating intracranial aneurysms, even those smaller than 3 mm. This study confirms the value of CTA as the primary imaging technique in subarachnoid haemorrhage, with DSA reserved for selected patients.