Background: The acquisition of a new 320-row multidetector computed tomography
angiography (CTA) scanner at the Montreal Neurological Institute and
Hospital has provided higher quality imaging with less radiation exposure
and shorter time of acquisition. However, its reliability has not been fully
proven in critical vascular lesions when it comes to replacing a more
invasive examination such as cerebral angiography. We wished to validate the
accuracy of this equipment to investigate four common indications for
patients to undergo conventional digital subtraction angiography:
subarachnoid hemorrhage, vasospasm, unusual intracerebral hemorrhage, and
unruptured aneurysm. Methods: Radiological reports and relevant imaging from 82 consecutive
subjects who underwent a 320-row multidetector CTA followed by cerebral
angiography from February 2010 to February 2014 were retrospectively
analysed. A total of 102 cerebrovascular anomalies were found. Reports from
both imaging modalities were compared to determine the diagnostic accuracy
of CTA. Results: The overall sensitivity and specificity of 320-row multidetector CTA
for detecting cerebrovascular abnormalities were, respectively, 97.60% and
63.20%. Similar results were obtained for all four categories of clinical
indications. Conclusion: Results obtained from CTA were consistent with those obtained on
digital subtraction angiography regardless of the vascular pathology. To our
knowledge, this study is the first validating the accuracy of 320-row CTA in
diagnosing critical cerebrovascular lesions.