Diagnostic accuracy and inter-rater reliability of 64-multislice 3D-CTA compared to intra-arterial DSA for intracranial aneurysms

B. Franklin, J. Gasco, T. Uribe, R. H.A. vonRitschl, E. Hauck

    Research output: Contribution to journalArticle

    28 Scopus citations


    Catheter-based intra-arterial digital subtraction angiography (IADSA) is widely trusted for diagnosing cerebral aneurysms. However, three-dimensional CT angiography (3D-CTA) is evolving. This study compares the diagnostic performance and inter-rater reliability of 64-slice 3D-CTA and IADSA. Nineteen patients with 26 suspected cerebral aneurysms (23 with confirmed aneurysms, three negative controls) underwent both IADSA and 3D-CTA. Two independent reviewers assessed both imaging modalities for the presence of an aneurysm and subsequently described aneurysmal location, size, shape, orientation, and number of emanating arteries. Inter-observer agreement was followed to control for observer bias. The sensitivity of 3D-CTA was 78% and 96%, the negative predictive value (NPV) was 38% and 75%, and the accuracy of 3D-CTA was 81% and 96%. Both reviewers found 100% specificity and 100% positive predictive value (PPV). There was a clear correlation between 3D-CTA and IADSA for describing cerebral aneurysms. The authors conclude that 3D-CTA has equivocal diagnostic advantage but is less reliable for ruling out aneurysm presence. Anatomy, however, is superior with 3D-CTA.

    Original languageEnglish (US)
    Pages (from-to)579-583
    Number of pages5
    JournalJournal of Clinical Neuroscience
    Issue number5
    StatePublished - May 1 2010



    • Computed tomography angiography
    • Digital subtraction angiography
    • Intracranial aneurysm

    ASJC Scopus subject areas

    • Surgery
    • Neurology
    • Clinical Neurology
    • Physiology (medical)

    Cite this