A study published by Yang et al in Radiology assessed the accuracy of computed tomographic (CT) angiography for diagnosis of cerebral aneurysms 5 mm or smaller.
A total of 1366 patients who underwent cerebral CT angiography followed by DSA were included in the study.
Of 1366 patients in their study, 579 patients had 711 small aneurysms at DSA. By using DSA as the reference standard, the respective sensitivity, specificity, and accuracy of CT angiography was analyzed for two readers. The sensitivity of CT angiography was lower for detection of aneurysms smaller than 3 mm that had not ruptured compared with aneurysms that were 3–5 mm and had ruptured (P < .001). No difference existed for the sensitivities of CT angiography for diagnosis of aneurysms in the anterior versus posterior circulation (P > .0167). Excellent or good inter-reader agreement was found for detection of intracranial aneurysms on a per-patient (κ = 0.982) and per-aneurysm (κ = 0.748) basis.
