64 Chapter 3 Abstract Background and purpose: Computed tomographic angiography (CTA) is used in our center as the primary diagnostic tool to detect and characterize intracranial aneurysms in patients presenting with a subarachnoid hemorrhage (SAH). Contrast enhanced magnetic resonance angiography (CEMRA) might be a possible alternative technique. In this study assessment by CEMRA of the feasibility of endovascular treatment of intracranial aneurysms with platinum coils, their “coilability”, is evaluated and compared to similar assessment using CTA. Materials and Methods: In 75 consecutive patients with a SAH two experienced neuroradiologists evaluated CEMRA and CTA images. Accuracy in predicting the coilability and determining the size of the aneurysms was calculated for both modalities and compared. Digital subtraction angiography (DSA) served as standard of reference. Results: 65 aneurysms were detected in 57 patients. No significant difference was found between the two modalities with respect to accuracy in assessing the feasibility of endovascular treatment: sensitivity and specificity for both were rather low (52.8-72.2 and 80.9-89.4 respectively) and Kappa was only 0.49 for both. Both modalities showed a little oversizing in the measurements of cerebral aneurysms. The intraclass correlation coefficient in size measurement was good for both modalities (0.93 and 0.91). Conclusion: The diagnostic performance of CEMRA does not differ significantly from that of CTA in the work up to endovascular treatment of patients presenting with an SAH. The choice to use either CEMRA or CTA can depend on personal preference and availability.
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