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Keywords
CTA
DSA
Intracranial aneurysm
Diagnostic performance
accuracy
How to Cite
Abstract
Background: Subarachnoid hemorrhage (SAH) is a significant cause of morbidity and mortality. Early and accurate aneurysm detection and evaluation are essential for effective treatment planning. Computed tomography angiography (CTA) provides a rapid, non-invasive diagnostic option, but its accuracy needs comparison with digital subtraction angiography (DSA), which remains the gold standard. Objective: To compare the diagnostic accuracy of CTA with DSA for detecting intracranial aneurysms in patients with spontaneous SAH. Methods & Materials: Thirty patients with spontaneous SAH were enrolled following IRB approval and informed consent. All underwent CTA at BMU and DSA at DMCH within 48–72 hours. DSA served as the gold standard. The sensitivity, specificity, PPV, NPV, and accuracy of CTA for aneurysm detection were calculated against DSA. Results: The mean age was 52.2 ± 9.8 years (range 32–72), with the highest incidence in the 51–60-year group (36.7%). Females predominated (63.3%), yielding a male-to-female ratio of 1:1.7. Hypertension (76.7%) was the most common risk factor, followed by smoking (33.3%). The leading presenting features were thunderclap headache and neck stiffness (63.3% each). CTA detected 31 aneurysms in 27 patients (90.0%). DSA detected 34 aneurysms in 28 patients (93.3%). Diagnostic performance of CTA demonstrated 96.4% sensitivity, 100% specificity, 100% PPV, 66.7% NPV, and 96.7% diagnostic accuracy. Conclusion: CTA demonstrated excellent diagnostic accuracy, comparable to invasive DSA, in detecting intracranial aneurysms among spontaneous SAH patients.
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