Digital subtraction CT angiography for the detection of posterior inferior cerebellar artery aneurysms: comparison with digital subtraction angiography

• Published in: European radiology 2017-09, Vol.27 (9), p.3744-3751
• Main Authors: Chen, Guo Zhong, Luo, Song, Zhou, Chang Sheng, Zhang, Long Jiang, Lu, Guang Ming
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aneurysm; Aneurysms; Angiography; Angiography, Digital Subtraction; Cerebellum; Cerebral Angiography - methods; Computed tomography; Computed Tomography Angiography - methods; Diagnostic Radiology; Diagnostic systems; Female; Head and Neck; Hemorrhage; Humans; Imaging; Internal Medicine; Interventional Radiology; Intracranial Aneurysm - diagnostic imaging; Male; Medical imaging; Medicine; Medicine & Public Health; Middle Aged; Neuroradiology; Patients; Posterior Cerebral Artery - diagnostic imaging; Radiology; Reference Standards; Retrospective Studies; Sensitivity; Sensitivity analysis; Sensitivity and Specificity; Ultrasound
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-017-4771-6

Objective To evaluate the diagnostic accuracy of digital subtraction CT angiography (DS-CTA) in detecting posterior inferior cerebellar artery (PICA) aneurysms with digital subtraction angiography (DSA) as reference standard. Methods A total of 115 patients, including 56 patients diagnosed with PICA aneurysms by CTA or DSA and 59 non-PICA-aneurysm patients were included in this retrospective study. All patients underwent DS-CTA and DSA. The site of PICA aneurysms and the pattern of haemorrhage were analysed. Sensitivity and specificity of DS-CTA without and with combining haemorrhage pattern in diagnosing PICA aneurysms were evaluated on a per patient and per aneurysm basis with DSA. Results Of 115 patients, 56 patients (48.7%) had 61 PICA aneurysms (size range, 1.1–13.5 mm; mean size, 4.9 ± 2.8 mm) on DSA. The sensitivity and specificity in depicting PICA aneurysms were 89.3% and 96.6% on a per patient basis and 90.2% and 93.4% on a per aneurysm basis, while the corresponding values were 94.6% and 96.6% on a per patient basis and 95.1% and 93.4% on a per aneurysm basis when combining with haemorrhage site. Conclusion DS-CTA has a high sensitivity and specificity in detecting PICA aneurysms compared with DSA. It may be helpful for clinical diagnosis of PICA aneurysms to combine with haemorrhage sites. Key Points • CT angiography has a good diagnostic performance in detecting PICA aneurysms. • The haemorrhage location is helpful to detect PICA aneurysms. • Digital subtraction CTA is a preferable diagnostic means for PICA aneurysms.