3-DIMENSIONAL CT ANGIOGRAPHY IN THE DETECTION AND CHARACTERIZATION OFINTRACRANIAL BERRY ANEURYSMS

PURPOSE: To assess the accuracy of three-dimensional CT angiography (C TA) in the detection and characterization of intracranial aneurysms an d to help determine its role as a screening test for aneurysms in the asymptomatic population and as an adjunct to angiography in subarachno id hemorrhages and in the follow-up of untreated aneurysms. METHODS: I n a blinded, prospective study, the 3-D CTA studies in 80 patients wit h symptomatic aneurysms were analyzed for the presence and morphology of aneurysms. Angiography or surgery acted as the control. RESULTS: Ni nety-four aneurysms were found in 63 patients. Negative findings at an giography were noted in 17. Sensitivity and specificity of 3-D CTA for all aneurysms, all patients, and aneurysms 5 mm or smaller were 90.4% and 50%, 98.4% and 82.4%, and 78.8% and 51.9%, respectively. CONCLUSI ON: Three-dimensional CTA may have a role in noninvasive screening for asymptomatic aneurysms in the general population, but caution is advo cated when data obtained from symptomatic patients are extrapolated to the asymptomatic population who harbor smaller aneurysms. Also, 3-D C TA may be useful as an adjunct to angiography in the characterization of berry aneurysms and in the follow-up of untreated aneurysms.