Comparing the diagnostic value of CT angiography and MR angiography in intracranial aneurysms

Objective: To assess and compare the overall diagnostic value of CT angiography and MR angiography in patients with suspected intracranial aneurysms. Methods: Articles published between 1990 and 2004 were searched in Cochrane library, Medline and Ovid database for relevant English-language articles and in Chinese Periodical Web for Chinese articles since 1994. Criteria for inclusion were established based on validity criteria for diagnostic research published by Cochrane Method Group On Screening and Diagnostic Test. Subsequently, the characteristics of the included articles were appraised and extracted. Statistical analysis was performed employing Meta-Test version 0.9. Heterogeneity of the included articles was tested, which was used to select proper effect model to calculate the pooled weighted sensitivity and specificity and the corresponding 95% CI. Characteristic (SROC) curve was performed and the area under the curve was calculated. Results: Eleven of 242 retrieved articles were included, in which there are four articles about CTA, and five about MRA, and two both CTA and MRA. Seven is prospectively studied and four is retrospectively. All groups had heterogeneity, and a random effects regression was developed. The pooled weighted sensitivity and specificity and area under SROC curve for CTA to per-aneurysm was 0.84(0.78-0.88), 0.77(0.68-0.84) and 95.40% respectively; MRA to per-aneurysm was 0.68(0.63-0.72), 0.76(0.70-0.82) and 79.71% respectively. Conclusion: With respect to diagnostic accuracy and conclusive result, CTA is more accurate than 3D TOF MRA in diagnosing intracranial aneurysms. (authors)