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CTA Useful in Detecting Ruptured Cerebral Aneurysms

CT angiography (CTA) has a nearly 100% detection rate in acute ruptured, cerebral aneurysms, according to a recent study conducted at the Health Sciences Center in Winnipeg, Canada.

The study consisted of 171 patients with acute subarachnoid hemorrhage (SAH) who underwent preoperative 3D CTA.

CTA correctly detected the ruptured aneurysm in 170 cases when compared to intraoperative findings, Bijal Patel, MD, lead author of the study. Of the 22 cases where there was more than one aneurysm, CTA correctly identified the ones that were ruptured every time. According to the study, the sensitivity of CTA was 99.4% in detecting the ruptured aneurysm in the setting of acute SAH. In the one case where CTA initially did not demonstrate the ruptured aneurysm, the study was severely degraded with motion artifact, said Dr. Patel.

While CTA provides detailed information on the features of the aneurysm, its true accuracy in the clinical setting could only be determined when compared to surgical findings, said Dr. Patel As in our institution and undoubtedly many others, it is the standard of practice to follow a confirmed SAH with a CTA. We felt it was important to perform a study that would evaluate the utility of CTA as the primary diagnostic investigation in detecting acute ruptured cerebral aneurysms using correlation with intraoperative findings, said Dr. Patel.

Although we were expecting CTA to demonstrate a high detection rate for acute ruptured aneurysms, we were not expecting the accuracy to be as high as it was. From the results of our study we concluded that CTA provides prompt and accurate diagnostic and anatomic information with a 99.4% detection rate in acute ruptured aneurysms, said Dr. Patel.

In cases of multiple aneurysms CTA is able to discern the ruptured one accurately. Furthermore, a positive CTA in the setting of acute spontaneous SAH is sufficient for intraoperative treatment planning, he said.


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