CHEN Yongchun,YANG Yunjun,XU Huazhi, et al. The screening value of 3D-CTA in determining the etiology of spontaneous ICH[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2015, 45(12): 907-.
Abstract：Objective: To assess the diagnostic accuracy of 64-slice three dimensional computed tomographic angiography (3D-CTA) for the etiology of spontaneous intracranial hemorrhage (ICH). Methods: From November 2013 to September 2014, 253 consecutive patients with ICH admitted to emergency department were included in this study and successively underwent 3D-CTA and DSA. All of the images of 3D-CTA and DSA were independently analysed by two neuroradiologists blinded, respectively. Then evaluate the accuracy of 3D-CTA for the etiology of ICH, compared with DSA as reference standard. Results: Among 253 patients, 27 patients were parenchymal hematoma, 12 patients were hemorrhage in ventricle system, and 214 patients were subarachnoid hemorrhage. DSA showed intracranial arteriovenous malformation in 17 patients, moyamoya disease in 13 patients, and intracranial aneurysm in 178 patients. The sensitivity and specificity of 64-slice 3D-CTA in the detection of the causes of ventricle system hemorrhage were both 100.0%, while in detection of the causes of parenchymal hematoma, the sensitivity and specificity were 90.9% and 100.0% respectively. Two patients with intracranial arteriovenous malformation less than 2 mm in diameter were omission. However, 3D-CTA missed 4 aneurysms, and misdiagnosed a small aneurysum in patients with subarachnoid hemorrhage, which made the sensitivity and specificity of 3D-CTA in detection of the causes of SAH lower (97.8% and 97.8% respectively). Conclusion: 3D-CTA has a high sensitivity and specificity for intracranial vascular disease, and can be used as the first choice of screening suspected intracranial aneurysms in emergency department. Moreover, 3D-CTA plays an important supplementary role in whole brain digital subtraction angiography for guiding aneurysm treatment.
