Computed Tomography Angiography with Three-Dimensional Reconstruction versus Rotational Angiography as a Screening Test in Patients with Suspected Cerebral Aneurysm

Abstract

Introduction The digital subtraction angiography is considered the gold standard in detecting cerebral aneurysms. Other less invasive techniques that require a lesser dose of contrast medium are currently employed such as rotational angiography (RA) and computed tomography angiography with three-dimensional reconstruction (3D-CTA). The aim of this study is to recommend 3D-CTA as a screening test for cerebral aneurysms in patients with suspected cerebrovascular pathology, having compared it to other tests requiring the use of less contrast medium, in this case, RA and 3D-CTA.

Materials and Methods The study was performed between 2010 and 2014 among all patients referred to the Centro Médico Nacional “20 de Noviembre” ISSSTE, in Mexico City, presenting a total of 332 patients with suspected cerebral aneurysm; 182 patients who had undergone angiography or digital subtraction angiography in a different hospital were not included, and 50 patients who tested negative for cerebral aneurysm were also excluded. Experts in neurological imaging examined the results, comparing those diagnosed with cerebral aneurysms, using RA and 3D-CTA against the gold standard.

Results Both RA and 3D-CTA registered the same aneurysm dimensions. Differences were observed in aneurysm's dome only.

Conclusion The RA should be reserved for those cases where a DSA is deemed necessary, but cannot be performed due to the high amount of contrast medium required and risk of adverse reactions in allergic population; in this case, the 3D-CTA is a better test.

Keywords

computed tomography angiography - cerebral aneurysm - rotational angiography - digital subtraction angiography

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