Subtraction CT angiography for evaluation of intracranial aneurysms: comparison with conventional CT angiography

The purpose of our study was to compare the diagnostic performance of subtraction computed tomography angiography (CTA) with conventional nonsubtracted CTA and digital subtraction angiography (DSA) for the detection of intracranial aneurysms. A total of 76 patients underwent both subtraction CTA and conventional CTA for the detection and therapy planning of suspected intracranial aneurysms. Subtraction and conventional CTA images were independently assessed by two readers in a blinded manner. The possibility of endovascular treatment or surgical clipping was also assessed based on information provided by CT angiograms alone. In 64 patients, 75 aneurysms were present on DSA. On a per-aneurysm basis, the sensitivity of subtraction CTA was 98.6% for reader 1, and 100% for reader 2. However, sensitivity of conventional CTA was 94.6% for reader 1, and 93.3% for reader 2. Therapeutic decisions could be made regarding 63 patients based on information provided by subtraction CTA images. However, conventional CTA provided sufficient information to make this decision for 55 patients. Conventional CTA has limited sensitivity in detecting very small aneurysms as well as aneurysms adjacent to bone. Subtraction CTA performed on a 64-row multidetector CT is an accurate and promising diagnostic tool that seems to be equivalent to 2D DSA for the detection and pretreatment planning of intracranial aneurysms.     

Detection and characterization of very small cerebral aneurysms by using 2D and 3D helical CT angiography

BACKGROUND AND PURPOSE: Many cases of subarachnoid hemorrhage are due to rupture of small cerebral aneurysms. Our purpose was to evaluate the usefulness of helical CT angiography (CTA) in the detection and characterization of very small (<5 mm) intracranial aneurysms. METHODS: One hundred eighty consecutive patients underwent CTA for suspected intracranial aneurysms. All aneurysms prospectively detected by CTA were confirmed by digital subtraction angiography (DSA) or at surgery. CT angiograms and digital subtraction angiograms were reviewed by two independent blinded radiologists who performed aneurysm detection, quantitation, and characterization using 2D multiplanar reformatted and 3D volume-rendering techniques. RESULTS: Fifty-one patients harboring 41 very small intracranial aneurysms were included in this series. Eighty-one percent (33 of 41 aneurysms) were 相似文献   

16层螺旋CT血管造影在颅内动脉瘤破裂中的临床应用

目的通过与DSA和手术对照,探讨16层螺旋CT血管造影（CTA）在颅内动脉瘤破裂的临床应用价值。资料与方法对33例动脉瘤性蛛网膜下腔出血（SAH）、脑出血患者进行回顾性分析,33例均使用16层螺旋CT进行了CTA检查,其中18例行DSA检查;6例DSA下介入治疗,27例开颅行动脉瘤颈夹闭术;将CTA与DSA和术中所见对照。结果33例中,CTA共发现动脉瘤36个,其中18例行DSA检查者中,CTA发现动脉瘤20个,DSA发现动脉瘤21个;CTA能够清晰显示动脉瘤瘤体（形态、指向、轮廓）、瘤颈的宽度、载瘤动脉及与颅骨之间的关系;与DSA和手术对照,CTA对动脉瘤的检出率为95．2％,对破裂动脉瘤的诊断敏感性和特异性均为100％。结论16层螺旋CT脑血管造影重组图像质量高,安全、快速、无创,可以作为颅内动脉瘤破裂首选的筛检方法。     

Detection of intracranial aneurysms with multislice CT: comparison with conventional angiography

We assessed the diagnostic accuracy of multislice CT in detection of intracranial aneurysms in patients presenting with subarachnoid or intracranial haemorrhage. Multislice CT and multiplanar digital subtraction angiography (DSA) images were obtained in 50 consecutive patients presenting with subarachnoid (SAH) and/or intracranial haemorrhage and reviewed by three neuroradiologists for the number, size and site of any aneurysms. The CT data were assessed using multiplanar reformats (MPR), maximum-intensity projections (MIP), surface-shaded display (SSD) and volume-rendering (VRT). In conventional angiography 51 aneurysms were detected in 41 patients. CT angiography (CTA) showed up to 48 aneurysms in 39 patients, depending on the observer. The overall sensitivity of multislice CT was 83.3% for small (<4 mm), 90.6% for medium-size (5–12 mm) and 100% for large (>13 mm) aneurysms. The sensitivity of multislice CTA to medium-size and large intracranial aneurysm is within the upper part of the range reported for helical single-slice CT. However, as small aneurysms may not be found, DSA remains the standard technique for investigation of SAH.     

Intracranial aneurysms: role of multidetector CT angiography in diagnosis and endovascular therapy planning

PURPOSE: To evaluate the sensitivity of 16-detector row computed tomographic (CT) angiography in diagnosis of intracranial aneurysms and to determine whether multidetector CT angiography provides sufficient diagnostic information to guide endovascular treatment, with combined imaging and clinical data as the reference standard. MATERIALS AND METHODS: Institutional review board approval and informed consent were obtained. Eighty-seven patients clinically suspected of having subarachnoid hemorrhage underwent multidetector CT angiography and digital subtraction angiography (DSA). Aneurysm detection with multidetector CT angiography and DSA was analyzed on a per-patient and a per-aneurysm basis. For each aneurysm deemed ruptured on multidetector CT angiograms, the same multidetector CT angiography data set was used to determine whether the aneurysm was suitable for endovascular coil placement or whether a neurosurgical procedure was preferable. Criteria were based on neck width in relation to aneurysm size and the presence of vessels originating from the aneurysm. Results were compared with actual treatment that had been performed in each aneurysm after full diagnostic work-up, including DSA. Sensitivity, specificity, and positive and negative predictive values for aneurysm presence were determined. RESULTS: The reference standard revealed 84 aneurysms in 63 patients. Multidetector CT angiography was used to correctly identify 62 of 63 patients with 80 of 84 aneurysms and to correctly rule out aneurysms in 24 patients. DSA was used to correctly identify 62 of 63 patients with 79 of 84 aneurysms and to correctly rule out aneurysms in 23 patients. Per patient, the sensitivity, specificity, and positive and negative predictive values, respectively, for presence of aneurysm(s) were 98%, 100%, 100%, and 96% for multidetector CT angiography and 98%, 100%, 98%, and 96% for DSA. Per aneurysm, the possibility of coil embolization was correctly assessed with multidetector CT angiography in 69 (93%) of 74 target aneurysms for acute occlusive treatment. CONCLUSION: Multidetector CT angiography offers high diagnostic accuracy-equivalent to that of DSA-in the detection of intracranial aneurysms. Also, the possibility of coil embolization can be reliably determined with multidetector CT angiography.     

Detection and evaluation of intracranial aneurysms with 16-row multislice CT angiography

AIM: The aim of this study was to assess the usefulness of 16-row multislice CT angiography (CTA) in evaluating intracranial aneurysms, by comparison with conventional digital subtraction angiography (DSA) and intraoperative findings. METHODS: A consecutive series of 57 patients, scheduled for DSA for suspected intracranial aneurysm, was prospectively recruited to have CTA. This was performed with a 16-detector row machine, detector interval 0.75 mm, 0.5 rotation/s, table speed 10mm/rotation and reconstruction interval 0.40 mm. CTA studies were independently and randomly assessed by two neuroradiologists and a vascular neurosurgeon blinded to the DSA and surgical findings. Review of CTA was performed on workstations with an interactive 3D volume-rendered algorithm. RESULTS: DSA or intraoperative findings or both confirmed 53 aneurysms in 44 patients. For both independent readers, sensitivity and specificity per aneurysm of DSA were 96.2% and 100%, respectively. Sensitivity and specificity of CTA were also 96.2% and 100%, respectively. Mean diameter of aneurysms was 6.3mm (range 1.9 to 28.1 mm, SD 5.2 mm). For aneurysms of less than 3 mm, CTA had a sensitivity of 91.7% for each reader. Although the neurosurgeon would have been happy to proceed to surgery on the basis of CTA alone in all cases, he judged that DSA might have provided helpful additional anatomical information in 5 patients. CONCLUSION: The diagnostic accuracy of 16-slice CTA is promising and appears equivalent to that of DSA for detection and evaluation of intracranial aneurysms. A strategy of using CTA as the primary imaging method, with DSA reserved for cases of uncertainty, appears to be practical and safe.     

全脑血管CT血管成像 数字减影血管造影检查和介入栓塞治疗在颅内动脉瘤中的诊断和治疗价值

目的探讨全脑血管CT血管成像（CTA）、数字减影血管造影（DSA）检查及介入栓塞治疗在颅内动脉瘤中的诊断和治疗价值。方法回顾性分析我院26例颅内动脉瘤病例的CTA与DSA资料,其中14例接受颅内动脉瘤的介入栓塞治疗。结果 CTA和DSA在颅内动脉瘤检出情况无明显差异;就显示动脉瘤大小,形态及其载瘤动脉和周围血管方面DSA检查优于CTA检查。14例动脉瘤介入栓塞治疗患者中无1例死亡,术后行DSA血管造影显示动脉瘤完全栓塞;2例术中出现血管痉挛,使用药物后缓解。结论CTA可以作为筛选颅内动脉瘤的首选检查方法,DSA在观察动脉瘤附近重要的穿支动脉血管方面明显优于CTA;介入栓塞治疗颅内动脉瘤是安全有效的,可以明显减少动脉瘤再次破裂出血,改善预后。     

Spiral CT angiography and surgical correlations in the evaluation of intracranial aneurysms

We investigated the accuracy of spiral computed tomography angiography (CTA) in the detection and study of intracranial aneurysms by comparing CTA with selective angiograms and surgical findings. Twenty-six patients (9 men and 17 women; mean age 53.1 ± 1.8 years) with suspected intracranial aneurysms were submitted to CTA (1- to 2-mm slices, pitch 1:1, 24 s, RI = 1) after a conventional CT examination showing subarachnoid hemorrhage (SAH) in 19 cases and during neuroradiological investigations performed for other reasons in 7 cases. One hundred twenty to 150 ml iodate contrast agent (0.3–0.4 gI/ml) were injected intravenously at 5 ml/s rate and with 12- to 25-s delay calculated with a preliminary test bolus. Three-dimensional shaded surface display (3D SSD) and maximum intensity projection (MIP) reconstructions were obtained from axial images. Then, within 48 h, all patients were submitted to digital subtraction angiography (DSA), with separate assessment of CTA and DSA findings. Twenty-two aneurysms shown by CTA were confirmed at DSA and surgery (true positives), whereas the vascular lesion was not confirmed at DSA in 2 cases (false positives). The presence of intracranial aneurysms was excluded at both CTA and subsequent DSA in 7 cases (true negatives) and there were no false negatives; sensitivity was 100 %, specificity 77.8 %, and diagnostic accuracy 93.5 %. Computed tomography angiography aneurysm location was confirmed at surgery in all cases, with very high accuracy in assessing the presence of an aneurysm neck (100 %). Computed tomography angiography accurately depicted the aneurysm shape in 20 of 22 cases, but failed to depict its multilobed nature in 2 cases. The mean aneurysm diameter calculated at CTA was 0.99 ± 0.12 cm vs 1.09 ± 0.11 cm at surgery (p < 0.01). The present results suggest that the high sensitivity of CTA, if confirmed by further studies, might help in avoiding having to resort to arteriography after negative CTA in SAH patients. Received 15 July 1997; Revision received 30 September 1997; Accepted 5 November 1997     

减影CTA成像技术在脑动脉瘤诊断中的优势

目的合理应用64层螺旋CT减影CTA的优势,提高对脑动脉瘤的诊断率。资料与方法对61例临床有蛛网膜下腔出血的患者行CT检查,并用减影CTA和常规CTA进行对比,重组技术用最大密度投影(MIP)和容积再现(VR)。以手术及部分DSA为标准评价两种检查结果;由两名有经验的神经外科医师、两名放射科医师双盲法评价图像质量。结果减影CTA检出动脉瘤63个,检出动脉瘤的敏感性为100%、特异性为100%,阴性似然比为0.0000,评价者对动脉瘤检出的一致性为1.00;常规CTA检出动脉瘤60个,漏检3个颈内动脉床突下动脉瘤,检出动脉瘤的敏感性为95%,特异性为100%,阴性似然比为0.0500,评价者对动脉瘤检出的一致性为0.9565。结论减影CTA技术对颈内动脉床突下动脉瘤的检出具有明显的优势。     

Comparison of the accuracy of subtraction CT angiography performed on 320-detector row volume CT with conventional CT angiography for diagnosis of intracranial aneurysms

Objective

The accuracy of diagnosis of intracranial aneurysms by subtraction computed tomography angiography (CTA) was compared with conventional non-subtracted CTA and with digital subtraction angiography (DSA).

Methods

56 patients with spontaneous subarachnoid hemorrhage (SAH) and suspected intracranial aneurysms were evaluated from September 2009 to January 2010. All underwent 320-detector row volume CT-CTA examinations. Non-contrast CT of each patient's head with the same scan range was performed before the routine CTA scan as the mask image for subtraction. The subtraction CTA volume data was obtained by subtracting the mask image volume data from the conventional non-subtracted CTA volume data. Subtraction and conventional CTA volume data were transmitted to a VOXAR workstation and two physicians with experience in diagnostic imaging of the nervous system independently carried out image post-processing and judged the results. Neurosurgeons performed endovascular treatment or surgical clipping based on information available through the CTA alone.

Results

In 42 patients, 51 aneurysms were detected by DSA. On a per-aneurysm basis, the diagnostic sensitivity of subtraction CTA was 98.9% for physician 1 and 100% for physician 2. The sensitivity of conventional CTA was 93.7% for physician 1 and 92.6% for physician 2. There was excellent inter-observer agreement (κ = 0.84, 95% confidence interval 0.82–0.85). The overall sensitivity, specificity, positive predictive and negative predictive values of subtraction CTA were all 100%. The overall sensitivity, specificity, positive predictive and negative predictive values of non-subtracted CTA were 94%, 100%, 100% and 76%, respectively. Therapeutic decisions could be made for all 42 patients based on subtraction CTA images, whereas conventional non-subtracted CTA provided sufficient information to make therapeutic decisions for only 35 patients.

Conclusion

Conventional CTA has lower sensitivity for the detection of very small aneurysms and aneurysms adjacent to the skull when compared to subtraction CTA. Subtraction CTA performed on a 320-detector row volume CT is an accurate diagnostic tool that provides data equivalent to that obtained with three-dimensional-DSA for the detection of intracranial aneurysms.     

64层3D-CTA与3D-DSA对颅内动脉瘤评价的对比研究

目的 对比评价64层螺旋CT三维血管造影(3D-CTA)与三维数字减影血管造影(3D-DSA)对颅内动脉瘤的诊断价值.方法 28例临床怀疑颅内动脉瘤的患者均行64层螺旋CT血管造影和DSA,CT三维后处理主要包括容积重建(VR)及最大密度投影(MIP).常规二维DSA检查后,对可疑病变血管行旋转DSA检查,应用三维工作软件行3D后处理,比较3D-CTA与3D-DSA对动脉瘤显示的价值.结果 28例病例中22例CTA和DSA均显示动脉瘤并经手术或栓塞证实,其中1例CTA和DSA显示单个动脉瘤,手术证实为2个动脉瘤,1例CTA显示假阳性.3D-CTA与3D-DSA均能清楚显示动脉瘤形状、瘤径指向、瘤体直径、瘤颈、载瘤动脉、瘤体穿动脉情况,两者无明显差异.结论 64层3D-CTA在颅内动脉瘤诊断及细节显示上与3D-DSA无明显差异,一定程度上应能替代血管造影,指导临床治疗.     

64层螺旋CT脑血管造影在颅内动脉瘤诊断中的应用

目的:与DSA相对照,探讨64层螺旋CT脑血管造影在颅内动脉瘤中的诊断价值。方法:对29例临床怀疑颅内动脉瘤的患者行64层螺旋CT脑血管造影(CTA)和DSA检查,使用GE64层Lightspeed VCT获得原始图像,所有病例均采用多层面重建(multiplanar reconstruction,MPR)、容积再现(volume rendering,VR)、薄层块最大密度投影(thin-slab maximumintensity projectjon,TS MIP)。后处理图像及DSA图像由2位放射科医生共同评估。结果:29例患者中,DSA证实25例共27个动脉瘤,其中2例为2个动脉瘤。与DSA结果相对照,CTA共检出25例26个动脉瘤,漏诊了1个颈出动脉瘤。CTA清晰显示了动脉瘤的形态、大小及载瘤动脉,3例动脉瘤瘤颈DSA未显示,CTA显示了全部动脉瘤的瘤颈。结论:64层CTA在颅内动脉瘤的诊断中具有极高价值,特别在显示动脉瘤瘤颈方面具有独特的优势,对临床治疗具有指导意义。     

Follow-up of intracranial aneurysms treated with detachable coils: comparison of gadolinium-enhanced 3D time-of-flight MR angiography and digital subtraction angiography

PURPOSE: To compare three-dimensional (3D) time-of-flight magnetic resonance (MR) angiography with digital subtraction angiography (DSA) in the follow-up of intracranial aneurysms treated with selective endovascular placement of detachable coils. MATERIALS AND METHODS: Sixty-eight consecutive patients with intracranial aneurysms were included in the prospective study. The goal was to evaluate 3D time-of-flight MR angiography versus DSA for the detection of a residual aneurysm neck or residual flow inside the coil mesh. RESULTS: Eighty-one MR angiographic and 83 DSA examinations were performed; 15 patients were examined with both modalities twice. MR angiography was not possible in two patients. In another patient, the quality of MR angiography was not sufficient to assess the treated aneurysm. In 72 of the remaining 80 MR angiographic and DSA examinations, there was good correlation between the two modalities. In 54 cases, neither image type showed remnants or recurrence, but in 18, both showed residual aneurysm. In eight cases, the MR angiographic and DSA results differed. In one of these cases, MR angiography depicted residual aneurysm but DSA depicted an arterial loop. In seven cases, a small (<3-mm) remnant was not detected at MR angiography. CONCLUSION: Because very small aneurysm remnants or recurrences probably are not clinically important, MR angiography is an option for following up intracranial aneurysms treated with detachable coils and may partly replace DSA.     

CT血管造影对脑动脉瘤的临床应用价值

目的 评价ＣＴ血管造影（ＣＡＴ）对脑动脉瘤的诊断价值。方法 脑动脉瘤,１９例行ＤＳＡ检查,１８例手术。用最大强度投影（ＭＩＰ）法进行血管重建。结果 ２０例患者中ＤＳＡ及手术发现２１个动脉瘤,ＣＴＡ发现０个。１９例为单发,１９例为单发,１例为多发（２个）,ＤＳＡ示位于基底动脉和左后交通动脉,ＣＴＡ未能显示后者动脉径为３～３３ｍｍ。１例有血管。靶重建、ＣＴＡ像与原始图像后交通动脉,ＣＴＡ像与原有显始图     

64层螺旋CT数字减影术对颅内动脉瘤诊断价值研究

目的 评价64层螺旋CT数字减影技术对颅内动脉瘤的诊断价值.方法 对36例蛛网膜下腔出血患者行64层螺旋CT平扫及增强扫描,每例患者均行常规CTA及减影CTA(digital subtraction CTA,DSCTA)重建,以DSA检查结果为标准,对比研究2种重建技术的图像质量、诊断准确性.结果 36例患者共计40个动脉瘤,经DSCTA检出动脉瘤40个,灵敏度、特异度分别为100%,经常规CTA检出动脉瘤37个,灵敏度、特异度分别为92.5%和100%.2组后处理图像质量单项有序行乘列表秩和检验有显著性差异(P＜0.01),DSCTA图像质量优于常规CTA.结论 64层螺旋CT DSCTA可作为筛查及诊断动脉瘤的首选方法.     

16层CT血管造影在颅内动脉瘤诊断及术后评价中的应用

目的探讨16层螺旋CT血管造影(CTA)对颅内动脉瘤的诊断价值,以及对动脉瘤夹闭术后评价其指导价值.资料与方法回顾性分析23例临床怀疑为颅内动脉瘤,并进行了16层CTA和DSA检查的病例,以DSA作为参考标准,评价16层CTA诊断价值.搜集6例动脉瘤钛夹夹闭病例进行术后评价,术前术后均进行了CTA检查,通过比较两次CTA结果评价动脉瘤夹闭情况.结果根据DSA资料及手术结果,16层CTA发现颅内动脉瘤的敏感性为81.5%,特异性为100%,准确性为84.4%.6例动脉瘤钛夹夹闭术后CTA随访中,与术前CTA相比,颅内大血管均未见狭窄或闭塞,但1例可见较为明显的瘤体残留.结论 16层CTA诊断颅内动脉瘤具有较好的特异性和敏感性,以及较好的三维显示能力,具有一定的临床应用价值.但对颈内和椎动脉动脉瘤,CTA仍然存在着一定困难.在动脉瘤夹闭术后评价方面,CTA能够清楚地显示瘤夹位置及载瘤动脉的通畅程度,但对于判断瘤颈及瘤体残留方面,其准确性有待DSA的进一步证实.     

Vasospasm after subarachnoid hemorrhage: utility of perfusion CT and CT angiography on diagnosis and management

PURPOSE: To evaluate the utility of perfusion CT (PCT) combined with CT angiography (CTA) for the diagnosis and management of vasospasm, by using conventional digital subtraction angiography (DSA) as the gold standard. METHODS: We retrospectively identified 27 patients with acute subarachnoid hemorrhage who had undergone CTA/PCT, DSA, and transcranial Doppler (TCD) ultrasonography within a time interval of 12 hours of one another. The patients' charts were reviewed for treatment of vasospasm. CTA, PCT, TCD, and DSA examinations were independently reviewed and quantified for vasospasm. PCT thresholds, CTA findings, noncontrast CT (NCT) hypodensities, and TCD thresholds were evaluated for accuracy, sensitivity, and specificity, as well as for negative (NPV) and positive predictive values (PPV) in the prediction of angiographic vasospasm and endovascular treatment, considering DSA as the gold standard. RESULTS: Thirty-five CTA/PCT, TCD, and DSA examinations were performed on these 27 patients. A total of 123 arterial territories in 11 patients demonstrated angiographic vasospasm. Six patients underwent endovascular therapy. CTA qualitative assessment and PCT-derived mean transit time (MTT) with a threshold at 6.4 seconds represented the most accurate (93%) combination for the diagnosis of vasospasm, whereas MTT considered alone represented the most sensitive parameter (NPV, 98.7%). A cortical regional cerebral blood flow value 相似文献   

16层螺旋CT血管造影在颅内动脉瘤中的应用价值

目的探讨16层螺旋CT血管造影(CTA)对颅内动脉瘤的诊断价值。方法28例疑有颅内动脉瘤患者均行16层CTA和DSA检查,对CTA的表现结合DSA和手术结果进行回顾性分析。结果本组28例经CTA共检出动脉瘤27个,其中25个经手术和DSA证实。1例CTA显示动脉瘤2个,DSA只显示1个,另1例CTA显示可疑动脉瘤2个,DSA显示正常。16层CTA诊断颅内动脉瘤的敏感性为89.2%,特异性为100%,准确性为96.4%。结论16层CTA在显示颅内动脉瘤方面可与DSA媲美,有重要临床应用价值。     

Intracranial aneurysms: evaluation using CTA and MRA. Correlation with DSA and intraoperative findings

Computed tomographic angiography (CTA) and magnetic resonance angiography (MSA) have been used recently for evaluation of intracranial aneurysms. If they are to replace conventional digital subtraction angiography (DSA), their sensitivity and specificity should be equal to the latter. In order to determine whether computed tomographic angiography and magnetic resonance angiography can provide the necessary information for presurgical evaluation we compared blindly the results of helical CT angiography and MR angiography with the results of digital subtraction angiography and the intraoperative findings. We evaluated 35 patients with the possible clinical diagnosis of intracranial aneurysm. Our data suggest that both CTA and MRA can provide valuable preoperative information concerning the location, the characteristics and the relationships of most intracranial aneurysms. Both original and reconstructed images should be evaluated together for higher accuracy. In addition helical CT, being a fast, inexpensive and noninvasive method, can be used as a reliable alternative to DSA in emergency situations demanding immediate operation.     

CT angiography,MR angiography and rotational digital subtraction angiography for volumetric assessment of intracranial aneurysms. An experimental study

The purpose of our experimental study was to assess the accuracy and precision of CT angiography (CTA), MR angiography (MRA) and rotational digital subtraction angiography (DSA) for measuring the volume of an in vitro aneurysm model. A rigid model of the anterior cerebral circulation harbouring an anterior communicating aneurysm was connected to a pulsatile circuit. It was studied using unenhanced 3D time-of-flight MRA, contrast-enhanced CTA and rotational DSA angiography. The source images were then postprocessed on dedicated workstations to calculate the volume of the aneurysm. CTA was more accurate than MRA (P=0.0019). Rotational DSA was more accurate than CTA, although the difference did not reach statistical significance (P=0.1605), and significantly more accurate than MRA (P<0.00001). CTA was more precise than MRA (P=0.12), although this did not reach statistical significance. Rotational DSA can be part of the diagnosis, treatment planning and support endovascular treatment of intracranial aneurysms. The emerging endovascular treatment techniques which consist of using liquid polymers as implants to exclude aneurysms from arterial circulation would certainly benefit from this precise measurement of the volume of aneurysms.