Computed Tomography Angiography Compared to Catheter Based Angiography in Evaluation of Cerebral Arterial Aneurysm and Arteriovenous Malformation
Author(s)
Sahar M. Badr,
Zuber Ahmed,
Maway A. Khafaji,
Khalid G. H. Alsafi,
Hanan Y. Abbas,
Saddig D. Jastaniah*
Affiliation(s)
Department of Diagnostic Radiology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, KSA. Department of Radiology, School of Medicine, King Abdulaziz University, Jeddah, KSA.
Department of Diagnostic Radiology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, KSA. Department of Radiology, School of Medicine, King Abdulaziz University, Jeddah, KSA.
ABSTRACT
Both cerebral arterial aneurysm and arteriovenous malformation are cerebrovascular disease, which required immediate diagnosis and urgent treatment. Since the introduction of multislice CT scanners, CT angiography (CTA) has become a powerful tool for imaging the vascular system. The goal of this study is to compare catheter based angiography and CTA in the evaluation of cerebral arterial aneurysm and arteriovenous malformation AVM. A retrospective analysis of 50 patients for exploring the record of patient who underwent both multislice CT angiography (MSCTA) and catheter based angiography before treatment is presented during last one year in the department of Radiology, King Fahd Hospital-Jeddah, Kingdom of Saudi Arabia. The sensitivity of CTA for picking up aneurysm is 86% and the sensitivity of catheter based angiography for picking up aneurysm is 97%. The specificity of CTA for picking up aneurysm is (76%), the false positive cases are (3%) and the false negative cases are 10%. The sensitivity of both CTA and catheter based angiography for picking up arteriovenous malformation is (90%). The specificity of CTA for picking up AVM is (76%), the false positive cases are (10%) and no false negative cases in CTA are found. The sensitivity and specificity of catheter based angiography is 100% in diagnosis and detection of cerebral arterial aneurysm and AVM. The present study concluded that CTA has high sensitivity and specificity in detecting aneurysm and AVM enough to be chosen as the first step. Catheter based angiography, still a gold standard for radiology examination, is the most accurate, sensitive and specific method in diagnosis and detection of cerebral arterial aneurysm and arteriovenous malformation, which can be done as the second step. In addition, catheter based angiography is done for treatment planning, treatment with interventional procedure and for prognosis after treatment.
Both cerebral arterial aneurysm and arteriovenous malformation are cerebrovascular disease, which required immediate diagnosis and urgent treatment. Since the introduction of multislice CT scanners, CT angiography (CTA) has become a powerful tool for imaging the vascular system. The goal of this study is to compare catheter based angiography and CTA in the evaluation of cerebral arterial aneurysm and arteriovenous malformation AVM. A retrospective analysis of 50 patients for exploring the record of patient who underwent both multislice CT angiography (MSCTA) and catheter based angiography before treatment is presented during last one year in the department of Radiology, King Fahd Hospital-Jeddah, Kingdom of Saudi Arabia. The sensitivity of CTA for picking up aneurysm is 86% and the sensitivity of catheter based angiography for picking up aneurysm is 97%. The specificity of CTA for picking up aneurysm is (76%), the false positive cases are (3%) and the false negative cases are 10%. The sensitivity of both CTA and catheter based angiography for picking up arteriovenous malformation is (90%). The specificity of CTA for picking up AVM is (76%), the false positive cases are (10%) and no false negative cases in CTA are found. The sensitivity and specificity of catheter based angiography is 100% in diagnosis and detection of cerebral arterial aneurysm and AVM. The present study concluded that CTA has high sensitivity and specificity in detecting aneurysm and AVM enough to be chosen as the first step. Catheter based angiography, still a gold standard for radiology examination, is the most accurate, sensitive and specific method in diagnosis and detection of cerebral arterial aneurysm and arteriovenous malformation, which can be done as the second step. In addition, catheter based angiography is done for treatment planning, treatment with interventional procedure and for prognosis after treatment.
Cite this paper
Badr, S. , Ahmed, Z. , Khafaji, M. , Alsafi, K. , Abbas, H. and Jastaniah, S. (2014) Computed Tomography Angiography Compared to Catheter Based Angiography in Evaluation of Cerebral Arterial Aneurysm and Arteriovenous Malformation. Open Journal of Medical Imaging, 4, 117-125. doi: 10.4236/ojmi.2014.43017.
Badr, S. , Ahmed, Z. , Khafaji, M. , Alsafi, K. , Abbas, H. and Jastaniah, S. (2014) Computed Tomography Angiography Compared to Catheter Based Angiography in Evaluation of Cerebral Arterial Aneurysm and Arteriovenous Malformation. Open Journal of Medical Imaging, 4, 117-125. doi: 10.4236/ojmi.2014.43017.
References
[1] Brown Jr., R.D., Wiebers, D.O., Torner, J.C. and O’Fallon, W.M. (1996) Frequency of Intracranial Hemorrhage as a Presenting Symptom and Subtype Analysis: A Population Based Study of Intracranial Vascular Malformations in Olmsted County, Minnesota. Journal of Neurosurgery, 85, 29-32.
http://dx.doi.org/10.3171/jns.1996.85.1.0029 [2] Van Gijn, J., Kerr, R.S. and Rinkel G.J. (2007) Subarachnoid Haemorrhage. Lancet, 369, 306-318.
http://dx.doi.org/10.1016/S0140-6736(07)60153-6 [3] Chow, L.C. and Rubin, G.D. (2002) CT Angiography of the Arterial System. Radiologic Clinics of North America, 40, 729-749. [4] Goddard, A.J., Tan, G. and Becker, J. (2005) Computed Tomography Angiography for the Detection and Characterization of Intra-Cranial Aneurysms: Current Status. Clinical Radiology, 60, 1221-1236. [5] Villablanca, J.P., Nael, K., Habibi, R., Nael, A, Laub, G. and Finn, J.P. (2006) 3T Contrast-Enhanced Magnetic Resonance Angiography for Evaluation of the Intracranial Arteries: Comparison with Time-of-Flight Magnetic Resonance Angiography and Multislice Computed Tomography Angiography. Investigative Radiology, 41, 799-805. [6] Kato, K., Tomura, N., Takahashi, S., et al. (2003) Ischemic Lesions Related to Cerebral Angiography: Evaluation by Diffusion Weighted MR Imaging. Neuroradiology, 45, 39-43. [7] Vaphiades, M.S. and Horton J.A. (2005) MRA or CTA, That’s the Question. Survey of Ophthalmology, 50, 406-410. [8] Yang, Y.J., Chen, W.J., Zhang, Y., Wu, Z.B., Zhong, M., Tan, X.X., et al. (2007) Diagnostic Value of CTA and MRA in Intracranial Traumatic Aneurysms. Chinese Journal of Traumatology, 10, 29-33. [9] Cloft, H.J., Joseph, G.J. and Dion, J.E. (1999) Risk of Cerebral Angiography in Patients with Subarachnoid Hemorrhage, Cerebral Aneurysm, and Arteriovenous Malformation: A Meta-Analysis. Stroke, 30, 317-320.
http://dx.doi.org/10.1161/01.STR.30.2.317 [10] Parker, D.L., Tsuruda, J.S., Goodrich, K.C., Alexander, A.L. and Buswell, H.R. (1998) Contrast-Enhanced Magnetic Resonance Angiography of Cerebral Arteries: A Review. Investigative Radiology, 33, 560-572.
http://dx.doi.org/10.1097/00004424-199809000-00012 [11] Hahnel, S., Bender, J., Jansen, O., et al. (2001) Clinically Silent Cerebral Embolisms after Cerebral Catheter Angiography. Rofo, 173, 300-305 [12] Katzen, T.B. (2002) The Future of Catheter-Based Angiography: Implications for the Vascular Interventionalist. Radiologic Clinics of North America, 40, 689-692. [13] Kokkinis, C., Vlychou, M., Zavras, G.M., Hadjigeorgiou, G.M., Papadimitriou, A. and Fezoulidis, I.V. (2008) The Role of 3D-Computed Tomography Angiography (3D-CTA) in Investigation of Spontaneous Subarachnoid Haemorrhage: Comparison with Digital Subtraction Angiography (DSA) and Surgical Findings. British Journal of Neurosurgery, 22, 71-78.
http://dx.doi.org/10.1080/02688690701713862 [14] Yoon, D.Y., Lim, K.J., Choi, C.S., Cho B.M., Oh, S.M. and Chang, S.K. (2007) Detection and Characterization of Intracranial Aneurysms with 16-Channel Multidetector Row CT Angiography: A Prospective Comparison of Volume-Rendered Images and Digital Subtraction Angiography. AJNR, 28, 60-67.
[1] Brown Jr., R.D., Wiebers, D.O., Torner, J.C. and O’Fallon, W.M. (1996) Frequency of Intracranial Hemorrhage as a Presenting Symptom and Subtype Analysis: A Population Based Study of Intracranial Vascular Malformations in Olmsted County, Minnesota. Journal of Neurosurgery, 85, 29-32.
http://dx.doi.org/10.3171/jns.1996.85.1.0029 [2] Van Gijn, J., Kerr, R.S. and Rinkel G.J. (2007) Subarachnoid Haemorrhage. Lancet, 369, 306-318.
http://dx.doi.org/10.1016/S0140-6736(07)60153-6 [3] Chow, L.C. and Rubin, G.D. (2002) CT Angiography of the Arterial System. Radiologic Clinics of North America, 40, 729-749. [4] Goddard, A.J., Tan, G. and Becker, J. (2005) Computed Tomography Angiography for the Detection and Characterization of Intra-Cranial Aneurysms: Current Status. Clinical Radiology, 60, 1221-1236. [5] Villablanca, J.P., Nael, K., Habibi, R., Nael, A, Laub, G. and Finn, J.P. (2006) 3T Contrast-Enhanced Magnetic Resonance Angiography for Evaluation of the Intracranial Arteries: Comparison with Time-of-Flight Magnetic Resonance Angiography and Multislice Computed Tomography Angiography. Investigative Radiology, 41, 799-805. [6] Kato, K., Tomura, N., Takahashi, S., et al. (2003) Ischemic Lesions Related to Cerebral Angiography: Evaluation by Diffusion Weighted MR Imaging. Neuroradiology, 45, 39-43. [7] Vaphiades, M.S. and Horton J.A. (2005) MRA or CTA, That’s the Question. Survey of Ophthalmology, 50, 406-410. [8] Yang, Y.J., Chen, W.J., Zhang, Y., Wu, Z.B., Zhong, M., Tan, X.X., et al. (2007) Diagnostic Value of CTA and MRA in Intracranial Traumatic Aneurysms. Chinese Journal of Traumatology, 10, 29-33. [9] Cloft, H.J., Joseph, G.J. and Dion, J.E. (1999) Risk of Cerebral Angiography in Patients with Subarachnoid Hemorrhage, Cerebral Aneurysm, and Arteriovenous Malformation: A Meta-Analysis. Stroke, 30, 317-320.
http://dx.doi.org/10.1161/01.STR.30.2.317 [10] Parker, D.L., Tsuruda, J.S., Goodrich, K.C., Alexander, A.L. and Buswell, H.R. (1998) Contrast-Enhanced Magnetic Resonance Angiography of Cerebral Arteries: A Review. Investigative Radiology, 33, 560-572.
http://dx.doi.org/10.1097/00004424-199809000-00012 [11] Hahnel, S., Bender, J., Jansen, O., et al. (2001) Clinically Silent Cerebral Embolisms after Cerebral Catheter Angiography. Rofo, 173, 300-305 [12] Katzen, T.B. (2002) The Future of Catheter-Based Angiography: Implications for the Vascular Interventionalist. Radiologic Clinics of North America, 40, 689-692. [13] Kokkinis, C., Vlychou, M., Zavras, G.M., Hadjigeorgiou, G.M., Papadimitriou, A. and Fezoulidis, I.V. (2008) The Role of 3D-Computed Tomography Angiography (3D-CTA) in Investigation of Spontaneous Subarachnoid Haemorrhage: Comparison with Digital Subtraction Angiography (DSA) and Surgical Findings. British Journal of Neurosurgery, 22, 71-78.
http://dx.doi.org/10.1080/02688690701713862 [14] Yoon, D.Y., Lim, K.J., Choi, C.S., Cho B.M., Oh, S.M. and Chang, S.K. (2007) Detection and Characterization of Intracranial Aneurysms with 16-Channel Multidetector Row CT Angiography: A Prospective Comparison of Volume-Rendered Images and Digital Subtraction Angiography. AJNR, 28, 60-67.