Diagnostic accuracy and inter-rater reliability of 64-multislice 3D-CTA compared to intra-arterial DSA for intracranial aneurysms.

Journal Article (Journal Article)

Catheter-based intra-arterial digital subtraction angiography (IADSA) is widely trusted for diagnosing cerebral aneurysms. However, three-dimensional CT angiography (3D-CTA) is evolving. This study compares the diagnostic performance and inter-rater reliability of 64-slice 3D-CTA and IADSA. Nineteen patients with 26 suspected cerebral aneurysms (23 with confirmed aneurysms, three negative controls) underwent both IADSA and 3D-CTA. Two independent reviewers assessed both imaging modalities for the presence of an aneurysm and subsequently described aneurysmal location, size, shape, orientation, and number of emanating arteries. Inter-observer agreement was followed to control for observer bias. The sensitivity of 3D-CTA was 78% and 96%, the negative predictive value (NPV) was 38% and 75%, and the accuracy of 3D-CTA was 81% and 96%. Both reviewers found 100% specificity and 100% positive predictive value (PPV). There was a clear correlation between 3D-CTA and IADSA for describing cerebral aneurysms. The authors conclude that 3D-CTA has equivocal diagnostic advantage but is less reliable for ruling out aneurysm presence. Anatomy, however, is superior with 3D-CTA.

Full Text

Duke Authors

Cited Authors

  • Franklin, B; Gasco, J; Uribe, T; VonRitschl, RHA; Hauck, E

Published Date

  • May 2010

Published In

Volume / Issue

  • 17 / 5

Start / End Page

  • 579 - 583

PubMed ID

  • 20207150

Electronic International Standard Serial Number (EISSN)

  • 1532-2653

Digital Object Identifier (DOI)

  • 10.1016/j.jocn.2009.09.015


  • eng

Conference Location

  • Scotland