ACCURACY OF THE MRA FOR THE DETECTION OF INTRACRANIAL ANEURYSM AS COMPARED TO THE CATHETER ANGIOGRAM
Keywords:
MRA, SAH, Aneurysm, SAH = Subarachnoid Haemorrhage, SCA = Superior Cerebellar Artery, 3DTOF = 3 dimentional Time of Flight, DAVF = Dural AV Fistular, MIP = Maximum Intensity ProjectionAbstract
Purpose: To assess the role of MRA for detection of intracranial aneurysm as compared to catheter angiogram by using standard method of post processing (MIP) in blinded-reader study.
Material and Method: Two hundred vessels were examined with catheter angiogram and 3DTOF MRA in SO patients with SAH (38 aneurysms ,1 DAVF and 13 patients with no aneurysm at DSA). MRA were interpreted by neuroradiologist blinded to the DSA results for presence, location, size and morphology of the aneurysm.
Results: Mean sensitivity for detection of aneurysm was 92.1% specificity 100%,positive predictive value 100%and negative predictive value 81.3%. 38 aneurysms were found; A-com 14, P-com 8, MCA 7, Basilar 4, ICA 3, SCA 1, vertebral 1, 1 DAVF and 13 no aneurysm. True positive 35, true negative 13,false positive 0 and false negative 3.
Conclusion: MRA with standard post processing can result in high sensitivity and specific studies for the diagnosis of intracranial aneurysm that are of sufficient size to be considered for surgical treatment. The positive predictive value is also very high but the negative predictive value is not high enough. Therefore, in negative study of MRA, cather angiogram is still recommended.
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