EVALUATION OF INTRA CRANIAL ANEURYSMS (ICA) BY MULTIDETECTOR COMPUTED TOMOGRAPHY ANGIOGRAPHY (MDCTA)

Abstract

INTRODUCTION: Digital subtraction angiography (DSA) is considered as gold standard for the detection and therapeutic decision making regarding ICA. However, DSA is invasive and costly as compared to CTA, which is accurate, easy, noninvasive and readily available and provide pragmatic information regarding appropriate management of ICA. METHODS: Retrospective case series with short term follow up of patients diagnosed with ICA on MDCTA between year 2006 and 2009 at our diagnostic radiology centre. CTA was performed on Toshiba aquilion 64 slice MDCT machine. Two dimensional maximum intensity projection (MIP) views and three dimension volume rendered reconstructions were done from raw images. The presence of an aneurysm, size, number, morphology, its parent and feeding vessels and associated findings i.e. hemorrhage & spasm were noted. RESULTS: We found 18 patients with ICA, three were excluded. In 15 patients, mean age ± standard deviation was 45.8 ±13.8. Six were males (40%) and 9 females (60%) with mean length ± standard deviation of aneurysm was 7.6 ±3.6 (3-12 mm) and width of 6.2±2.5 (2-10 mm). All had single aneurysm; middle cerebral artery was most common site. Signs of ruptured aneurysm were found in nine (53%) and two expired (17.9%). CONCLUSION: Our case series supports the use of MDCTA alone for the effective evaluation of ICA of greater or equal to 2 mm without any further investigations.