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Abstract
Objective : The purpose of this retrospective study is to determine the
accuracy of maximum intensity projection (MIP) images of computed tomographic
angiography (CTA) for diagnosis of cerebral vasospasm (CV)
following subarachnoid hemorrhage (SAH) compared with that of digital
subtraction angiography (DSA).
Materials and Methods : For patients admitted to our hospital for SAH,
MIP images of CTA and DSA were checked at admission, and images
were taken again 1 week later. This protocol was used in 39 cases. MIP
images of CTA and DSA examinations were reviewed by two independent
readers.
Results : Accuracy of MIP images of CTA in various arterial segments, using
DSA as the gold standard: the sensitivity, specificity, positive predictive
value (PPV), negative predictive value (NPV), and accuracy for different
segments varied from 84 to 97, 33-100, 84-100%, 25-85, and 79-97%, respectively,
for readers. Accuracy of CTA in various vasospasm severity, using
DSA as the gold standard: the sensitivity, specificity, PPV, NPV, and
accuracy for different vasospasm severity varied from 44 to 100, 69-100,
36-100%, 61-100, and 88-100%, respectively, for readers. Accuracy of CTA
in central segments versus peripheral segments, using DSA as the gold
standard: the sensitivity, specificity, PPV, NPV, and accuracy for central
segments and peripheral segments varied from 90 to 94, 68-83, 93-97%,
56-69, and 87-93%, respectively, for readers.
Conclusion : MIP imaging of CTA is a useful modality when diagnosing
CV after SAH. |
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Key words : Angiography, Digital subtraction, Vasospasm, Intracranial |
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