Detection and Evaluation of Intracranial Aneurysms with 3D-CT Angiography and Compatibility of Simulation View with Surgical Observation

The aim of this study was to report our experience with a 64-channel computerized tomography (CT) scanner as the primary choice on the detection of intracranial aneurysms. Comparison of intracranial aneurysms with the simulated images obtained via three-dimensional computed tomography angiography (3D-CTA) in pterional approach was also aimed. Among 288 consecutive patients who had intracranial aneurysms detected on 64-slice CTA, a total of 337 aneurysms were detected. CTA simulation images and intraoperative images were compared with regards to size, shape, and orientation. In one of the 22 CTA-negative cases, one aneurysm was detected in DSA and an additional aneurysm was detected in a patient operated with CTA. Aneurysm size, shape and direction were error free except a few cases. However, CTA was found to be insufficient to show particularly perforating arteries that were smaller than 2 mm in size. As a fast and noninvasive technique, CTA can be used as an initial examination in subarachnoid hemorrhage. Keeping the fact that there can be insufficiency in showing particularly small aneurysms in mind, DSA should be performed on CTA-negative cases and required cases.