Diagnostic accuracy of three dimentional digital substraction angiography (3d DSA) in correlation with computed tomographic angiography (CTA) and magnetic resonance angiography (MRA) in evaluation of aneurysmal subarachnoid haemorrhage : a comparative study in a tertiary care hospital

Subarachnoid hemorrhage from ruptured intracranial aneurysm is a serious condition, which can only be prevented by early diagnosis and treatment before rupture. In this study, we have assessed the performance of CTA and MRA in detecting, localizing and sizing intracranial aneurysms in patients of aneurysmal subarachnoid haemorrhage compared to 3D DSA and effects of above parameters on the sensitivity of these imaging modalities, taking DSA as gold standard. Methods:- We investigated 25 consecutive patients of subarachnoid haemorrhage referred to our department between November 2017 and April 2018 after they met the inclusion criteria. Each patients underwent CTA, MRA and conventional rotational digital substraction angiography from which three dimentional reconstructed images were obtained and the findings were recorded and analysed. Results:- We found that the sensitivity of each of CTA and MRA for identification of intracranial aneurysms is 57.1 % in small, 88.8 % in medium and 100% in large sized aneurysms. Overall, both CTA and MRA were 20% less sensitive than 3D DSA in detection of intracranial aneurysms, specially for small and medium sized ones. Conclusion:- Hence, 3D DSA is more sensitive and accurate for evaluation of aneurysmal subarachnoid hemorrhage than CTA and MRA. (author)