scholarly journals Comparison of CTA to DSA in Determining the Etiology of Spontaneous ICH

2009 ◽  
Vol 36 (2) ◽  
pp. 176-180 ◽  
Author(s):  
Robert Yeung ◽  
Tabassum Ahmad ◽  
Richard I. Aviv ◽  
Lyne Noel de Tilly ◽  
Allan J. Fox ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Predictive Value ◽  
Computed Tomographic Angiography ◽  
Lower Sensitivity ◽  
Study Cohort ◽  
Computed Tomographic ◽  
Arteriovenous Fistulas ◽  
Kappa Value ◽  
Sensitivity Specificity ◽  
Tomographic Angiography

Background and Purpose:To compare the efficacy of computed tomographic angiography (CTA) to that of digital subtraction angiography (DSA) in the detection of secondary causes of intracerebral hemorrhage (ICH).Methods:Between January 2001 and February 2007 there were 286 patients that had both CTA and DSA for intracranial hemorrhage of all types. Those with primarily subarachnoid hemorrhage or recent trauma were excluded. Fifty-five patients formed the study cohort. Three reviewers independently analyzed the CTAs in a blinded protocol and classified them based on presence or absence of a secondary etiology. Results were compared with the reference standard DSA and kappa values determined for interobserver variability.Results:The overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CTA were 89%, 92%, 91%, 91% and 91%, respectively. Kappa value for interobserver agreement ranged from 0.78 to 0.89. Two of four dural arteriovenous fistulas (dAVF) were missed on CTA by all three reviewers.Conclusion:CTA is nearly as effective as DSA at determining the cause of secondary intracerebral hemorrhage, but with a lower sensitivity for dAVFs. This supports the use of CTA as the first screening test in patients presenting with spontaneous ICH.

Additional value of deep learning computed tomographic angiography-based fractional flow reserve in detecting coronary stenosis and predicting outcomes

2021 ◽  
pp. 028418512098397
Author(s):  
Yang Li ◽  
Hong Qiu ◽  
Zhihui Hou ◽  
Jianfeng Zheng ◽  
Jianan Li ◽  
...  
Keyword(s):  
Deep Learning ◽  
Unstable Angina ◽  
Fractional Flow Reserve ◽  
Predictive Value ◽  
Computed Tomographic Angiography ◽  
Fractional Flow ◽  
Computed Tomographic ◽  
Flow Reserve ◽  
Sensitivity Specificity ◽  
Tomographic Angiography

Background Deep learning (DL) has achieved great success in medical imaging and could be utilized for the non-invasive calculation of fractional flow reserve (FFR) from coronary computed tomographic angiography (CCTA) (CT-FFR). Purpose To examine the ability of a DL-based CT-FFR in detecting hemodynamic changes of stenosis. Material and Methods This study included 73 patients (85 vessels) who were suspected of coronary artery disease (CAD) and received CCTA followed by invasive FFR measurements within 90 days. The diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristics curve (AUC) were compared between CT-FFR and CCTA. Thirty-nine patients who received drug therapy instead of revascularization were followed for up to 31 months. Major adverse cardiac events (MACE), unstable angina, and rehospitalization were evaluated and compared between the study groups. Results At the patient level, CT-FFR achieved 90.4%, 93.6%, 88.1%, 85.3%, and 94.9% in accuracy, sensitivity, specificity, PPV, and NPV, respectively. At the vessel level, CT-FFR achieved 91.8%, 93.9%, 90.4%, 86.1%, and 95.9%, respectively. CT-FFR exceeded CCTA in these measurements at both levels. The vessel-level AUC for CT-FFR also outperformed that for CCTA (0.957 vs. 0.599, P < 0.0001). Patients with CT-FFR ≤0.8 had higher rates of rehospitalization (hazard ratio [HR] 4.51, 95% confidence interval [CI] 1.08–18.9) and MACE (HR 7.26, 95% CI 0.88–59.8), as well as a lower rate of unstable angina (HR 0.46, 95% CI 0.07–2.91). Conclusion CT-FFR is superior to conventional CCTA in differentiating functional myocardial ischemia. In addition, it has the potential to differentiate prognoses of patients with CAD.

Multi-Slice Computed Tomographic Angiography for Stenosis Detection in Forearm Hemodialysis Arteriovenous Fistulas

2008 ◽  
Vol 9 (4) ◽  
pp. 278-284 ◽  
Author(s):  
P.P.G.M. Rooijens ◽  
G.P Serafino ◽  
D. Vroegindeweij ◽  
R. Dammers ◽  
T.I. Yo ◽  
...  
Keyword(s):  
High Specificity ◽  
Computed Tomographic Angiography ◽  
Observer Agreement ◽  
Predictive Values ◽  
Computed Tomographic ◽  
Arteriovenous Fistulas ◽  
Blinded Manner ◽  
Sensitivity Specificity ◽  
Tomographic Angiography ◽  
Diameter Reduction

Purpose A method of diagnosing the extent and severity of arteriovenous fistula (AVF) stenoses is multi-slice computed tomographic angiography (MS-CTA). The aim of this prospective study was to assess the accuracy of MS-CTA for the detection and grading of stenoses in AVF in comparison to digital subtraction angiography (DSA), which was used as the gold standard of reference. Methods Fifteen hemodialysis (HD) patients with dysfunctioning forearm AVF were included. These AVFs were evaluated by both DSA and MS-CTA and were read in a prospective, blinded manner by two radiologists experienced in vascular imaging. Results ROC analysis revealed areas under the curve of 0.90 ± 0.07 for observer I and 0.87 ± 0.08 for observer II at a stenosis cut-off level of ≥50% diameter reduction. The combined results for MS-CTA showed sensitivity, specificity and positive and negative predictive values of 82%, 98%, 82% and 98% for stenoses ≥50% and 71%, 99%, 77% and 98% for stenoses ≥75%. Inter-observer agreement for the detection of stenoses ≥50% diameter reduction was 0.70 and 1.0, for MS-CTA and DSA, respectively. Conclusion MS-CTA can provide good visualization of forearm HD access AVF and has moderate sensitivity, but high specificity for the detection of flow-limiting stenoses.

Acute intracerebral hemorrhage with a spot sign during computed tomographic angiography

2016 ◽  
Vol 16 (8) ◽  
pp. 976-977
Author(s):  
Kwang Hoon Kim ◽  
Hyun Goo Kang ◽  
Seong Hwan Ahn ◽  
Ji Yeon Chung ◽  
In Sung Choo ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Computed Tomographic Angiography ◽  
Spot Sign ◽  
Computed Tomographic ◽  
Acute Intracerebral Hemorrhage ◽  
Tomographic Angiography

scholarly journals Early Post-operative CT-Angiography Imaging After EC-IC Bypass Surgery in Moyamoya Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Helene Hurth ◽  
Till-Karsten Hauser ◽  
Patrick Haas ◽  
Sophie Wang ◽  
Annerose Mengel ◽  
...  
Keyword(s):  
Predictive Value ◽  
Bypass Surgery ◽  
False Positive Rate ◽  
Computed Tomographic Angiography ◽  
Clinical Value ◽  
Computed Tomographic ◽  
Bypass Patency ◽  
Imaging Results ◽  
Positive Rate ◽  
Tomographic Angiography

Objective: To evaluate the clinical value of early post-operative computed tomographic angiography (CTA) after direct extracranial-intracranial (EC-IC) bypass surgery in moyamoya patients.Methods: A retrospective analysis of all adult moyamoya patients treated at our center from 2013 to 2019 with a direct EC-IC bypass was performed. Early post-operative CTA (within 24 h after surgery) was compared with conventional digital subtraction angiography (DSA) 6–12 months after surgery. If available, magnetic resonance time-of-flight angiography (MR-TOF) was evaluated 3 months and 6–12 months post-operatively as well. Imaging results were analyzed and compared with CTA, MR-TOF and DSA, whereat DSA was used as the final and definite modality to decide on bypass patency.Results: A total of 103 direct EC-IC bypasses in 63 moyamoya patients were analyzed. All inclusion criteria were met in 32 patients (53 direct bypasses). In 84.9% the bypass appeared definitively, in 5.7% uncertainly and in 9.4% not patent according to early post-operative CTA. MR-TOF suggested definitive bypass patency in 86.8% 3 months after surgery and in 93.5% 6–12 months after surgery. DSA 6–12 months post-operatively showed a patency in 98.1% of all bypasses. The positive predictive value (to correctly detect an occluded bypass) on post-operative CTA was 12.5%, the negative predictive value (to correctly detect a patent bypass) was 100% with a sensitivity of 100% and a specificity of 86.5%.Conclusion: Early post-operative CTA has a high predictive value to confirm the patency of a bypass. On the other hand, a high false positive rate of (according to CTA) occluded bypasses after direct EC-IC bypass surgery can be seen. This must be considered critically when initiating possible therapeutic measures.

scholarly journals Diagnostic Validity of 3D-Computed Tomographic Angiography in Spontaneous Subarachnoid Haemorrhage

2019 ◽  
Vol 5 (1) ◽  
pp. 47-52
Author(s):  
Nur Mohammad ◽  
Jalal Uddin Mohammad Rumi ◽  
Sadia Jabeen Khan ◽  
Kalim Uddin ◽  
Patoary Mohammed Faruque
Keyword(s):  
Intracranial Aneurysm ◽  
Positive Predictive Value ◽  
Subarachnoid Haemorrhage ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Intracranial Aneurysms ◽  
Computed Tomographic Angiography ◽  
Diagnostic Validity ◽  
Computed Tomographic ◽  
Tomographic Angiography

Background: Diagnostic validity of different tests for the detection of spontaneous subarachnoid haemorrhage is an important issue. Objectives: The purpose of the present study was to validate 3D-Computed tomographic angiography in spontaneous subarachnoid haemorrhage. Methodology: This cross-sectional study was carried out in the Department of Neurosurgery and Cath Lab of DMCH in collaboration with private diagnostic centre from September 2013 to February 2015 for a period of six (06) months. Adult patients diagnosed as a case of spontaneous SAH based on clinical features and confirmed by plain CT evidence of subarachnoid blood were included as study population. Patients having current history of trauma, poor clinical grade and agitated patient, patient with renal insufficiency, known allergy to iodinated contrast agent and patients who were not willing participate in the study were excluded from this study. Then both CT angiography and DSA were performed to detect cause of bleeding and to make a treatment planning. In this study DSA was considered as reference standard for evaluation of CTA. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of CTA were calculated per patient basis and per aneurysmal basis. Result: A total number of 37 patients presented with spontaneous subarachnoid haemorrhage were recruited for this study. The mean age of patients was 58.53±7.54 years. Sensitivity and specificity in depicting intracranial aneurysms were, 93.75% and 100% respectively on a per-patient basis. Positive predictive value and negative predictive value of CTA are 100% and 71.43% respectively. CTA had shown 94.59% accuracy in detection of intracranial aneurysm. Sensitivity and specificity in depicting intracranial aneurysms were 94.74% and 100% respectively on a per-aneurysm basis. Positive predictive value and negative predictive value of CTA are 100% and 71.43% respectively. CTA had shown 95.35% accuracy in detection of intracranial aneurysm. Conclusion: In conclusion CTA has high detection capacity of aneurysm among spontaneous subarachnoid haemorrhage patients. Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 47-52

scholarly journals Rate of Contrast Extravasation on Computed Tomographic Angiography Predicts Hematoma Expansion and Mortality in Primary Intracerebral Hemorrhage

Stroke ◽  
2015 ◽  
Vol 46 (9) ◽  
pp. 2498-2503 ◽  
Author(s):  
H. Bart Brouwers ◽  
Thomas W.K. Battey ◽  
Hayley H. Musial ◽  
Viesha A. Ciura ◽  
Guido J. Falcone ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Computed Tomographic Angiography ◽  
Hematoma Expansion ◽  
Contrast Extravasation ◽  
Computed Tomographic ◽  
Tomographic Angiography
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