CTA IN PATIENTS WITH ACUTE SUBARACHNOID HAEMORRHAGE: A comparative study with selective, digital angiography and blinded, independent review

Authors: Pedersen, H.K.1; Bakke, S.J.1; Hald, J.K.1; Skalpe, I.O.1; Anke, I.M.2; Sagsveen, R.2; Langmoen, I.A.3; Lindegaard, K.F.3; Nakstad, P.H.1

Source: Acta Radiologica, 1 January 2001, vol. 42, no. 1, pp. 43-49(7)


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Minimal- or non-invasive methods replacing intra-arterial digital subtraction angiography (IA-DSA) would be of great importance in patients suffering from acute subarachnoid haemorrhage (SAH). The aims of this study were to compare CTA with IA-DSA in patients with acute SAH, to compare CTA interpretations with those of blinded, independent reviewers and to evaluate improvement in CTA diagnostics after 1 year of experience with CTA.

Material and Method:

During 2 years 162 patients with SAH underwent CTA as well as IA-DSA. Independent blinded review of 77 patients was performed for 1 year.


Totally 144 aneurysms were demonstrated in 119 patients at IA-DSA, while 43 patients had normal intracranial arteries. Initially 131 aneurysms were detected at CTA while 2 normal, tortuous arteries were misinterpreted as aneurysms, giving a sensitivity of 91% and a specificity of 95%. At independent blinded review the observer agreement was 87% and the kappa value 0.68.


CTA in SAH is of great value in demonstrating vascular anatomy and the exact size of an aneurysm. However, IA-DSA is still needed for diagnostic evaluation in aneurysms smaller than 5 mm in diameter, especially in those located near bony structures.

Keywords: Subarachnoid haemorrhage, cerebral aneurysm; computed angiography; intra-arterial digital subtraction angiography

Document Type: Original Article

DOI: http://dx.doi.org/10.1080/028418501127346224

Affiliations: 1: Departments of Radiology and 2: Department of Radiology, University Hospital of Tromsø, Tromsø, Norway. 3: Neurosurgery, The National Hospital, University of Oslo, Oslo and

Publication date: January 1, 2001

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