L'angio-TC nel riscontro e nell'analisi delle caratteristiche delle lesioni aneurismatiche intracraniche dei pazienti con ESA

This study retrospectively assessed the utility of angio-CT in the identification and analysis of intracranial aneurysms in patients with subarachnoid haemorrhage (SAH) using digital angiography (DA) as a gold standard. A cohort of 97 patients with subarachnoid haemorrhage was investigated by angio-CT within 12 hours of acute SAH; 23 patients had angio-CT alone, whereas 74 underwent both angio-CT and DA. On average DA was performed within 24h. We identified 69 aneurysms in the 74 patients undergoing both angio-CT and DA (six patients had a double aneurysm and one had four) and no aneurysms in 14 patients. Angio-CT failed to disclose the aneurysm in five cases, subsequently identified by DA. The false negative results were due to an error in calculating the injection delay in one case and in another the aneurysm in the PICA was not opacified. DA was performed on the following day and in the meantime the conditions of the circulation and vessels may have changed. The remaining patients had aneurysms which were not well displayed due to severe tortuosity of the vessel associated with small lesion size and bony structures very close to the lesion. The sensitivity and specificity of angio-CT in the identification of aneurysms were 96% and 100% re-spectively with an overall predictive value of 96%. This non-invasive technique proved quick, reliable and informative and often led to final diagnosis in SAH patients, especially in emergency patient management.