What is the most sensitive non-invasive strategy for the diagnosis of intracranial aneurysms?
- Department of Neurosurgery, University of Cambridge, Box 167, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ, UK
- Mr P J Hutchinson,p.hutch{at}which.net
In the paper by White et al (this issue, pp322–328)1 non-invasive tests for the detection of intracranial aneurysms are evaluated. Combining these tests is shown to improve the diagnostic performance, the combination of power Doppler and CT angiography having the greatest sensitivity (0.83) for aneurysm detection with a strong agreement with the gold standard of digital subtraction angiography (κ 0.84).
This paper shows that the performance of these non-invasive imaging techniques is improving. One of the concerns raised is that small aneurysms, of 5 mm or less, cannot be reliably identified. This concern has been diluted by findings of the International Study on Unruptured Intracranial Aneurysms (ISUIA)2 which indicated that aneurysms under the …
