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Krzysztof Kowalewski, Tomasz Turek, Marek Sasiadek, Barbara Hendrich, Jacek Podkowa, Hanna Maksymowicz
Med Sci Monit 2002; 8(6): MT
BACKGROUND: CT-angiography is a non-invasive method, alternative to cerebralangiography in the diagnosis of intracranial aneurysms. The aim of the study was the assessment of theefficiency of CT-angiography in a large material, which has been mostly verified with angiography and/orsurgery.MATERIAL/METHODS: CT-angiography was performed in 196 patients with intracranial bleeding. Seventy-three(73) patients underwent also cerebral angiography (CA), 121 were operated on, 74 of them solely on thebasis of CT-angiography. A spiral CT scanning (2 mm slices, 1-1.5 pitch, 1 mm-gap reconstruction) combinedwith an injection of 120 mL of contrast medium (5 mL/sec) was used. Subsequently three-dimensional MIPreconstructions were received, supplemented in some cases with SSD, VRT and MPR.RESULTS: CT-angiographyrevealed 128 aneurysms in 106 patients, located mostly in anterior communicating, middle cerebral andinternal carotid arteries. The size of most aneurysms was 6-10 mm, but nearly one-third of them did notexceed 5 mm. In the group of patients who underwent CA, there was only 1 false negative CT-angiographyresult, while in 7 patients CT-angiography allowed for the diagnosis of small aneurysms which were notclearly visible on CA. CT-angiography was superior to CA in assessment of aneurysm morphology by 3 independentradiologists in 17 out of 22 cases. CT-angiography findings were confirmed during surgery in all 74 patients.CONCLUSIONS:CT-angiography is highly effective in the diagnosis of intracranial aneurysms and the evaluation of theirmorphology. In our opinion, in most cases, CT-angiography is precise enough to plan a surgical or endovascularprocedure.