EVALUATION OF CT AND MR ANGIOGRAPHY IN DETECTION OF INTRACRANIAL ANEURYSMS - A LITERATURE REVIEW

CILJ: Usporediti radiološke dijagnostičke modalitete CTA i MRA u dijagnosticiranju intrakranijalnih aneurizmi . Nadalje, istražiti koja je dijagnostička metoda pouzdanija, sigurnija, kvalitetnija za dijagnosticiranje istih i kada se koriste. METODE: Pretraživanje znanstvene literature koristeći nekolicinu važnih baza znanja upotrebom izraza kompjuterizirana tomografska angiografija CTA, magnetska razonancijska angiografija MRA i intrakranijalna aneurizma, kroz naslove članaka, sažetke i ključne riječi. Baze podataka koje su pretražene jesu PubMed-Medline, Scopus. Pregledom meta-analizi, početna strategija pretraživanja dala je 376 relevantnih citata. Od njih, 174 članka su korištena za detaljnu procjenu, a 202 su isključena. Konačno, 97 članaka zadovoljilo je stroge kriterije uključivanja. REZULTATI : U ovoj studiji, AUC indeks korišten je za usporedbu razlike vrijednosti dijagnoze između CTA i MRA za intrakranijsku aneurizmu. Utvrdili smo da ne postoji značajna razlika između dvije metode (Z = 0.828, P> .05). Osjetljivost i specifičnost MRA za identifikaciju intrakranijalne aneurizme veličine preko 3 mm je 87 do 100% odnosno 86 do 100%, a osjetljivost i specifičnost CTA za dijagnosticiranje intrakranijalne aneurizme je 92,8 do 100%, odnosno 83 do 100%. ZAKLJUČAK: Obje slikovne metode imaju vrlo visoku i praktički jednaku dijagnostičku preciznost ( MRA osjetljivost i specifičnost 87-100 %, odnosno 86 - 100 %, CTA osjetljivost i specifičnost 92,8 do 100 %, odnosno 83 do 100 %) u otkrivanju i karakteriziranju intrakranijalnih aneurizmi. Radiološki tehnolog mora vladati znanjima o prednostima i nedostacima ove dvije metode, uz to mora biti kompetentan u izvođenju istih te pratiti najnovije standarde temeljene na znanstvenim istraživanjima u protokolima za dobivanje kvalitetnih dijagnostičkih informacija te primjenjivati iste u dogovoru s radiolozima.OBJECTIVE: Comparison of radiological diagnostic modalities CTA and MRA in the diagnosis of intracranial aneurysms as dilatations of cerebral arteries caused by hemodynamic factors and changes occurring in the arterial wall. Furthermore, to find out which diagnostic method is more reliable, safer, of better quality for diagnosing them and when they are used. METHODS: Comprehensive literature search using several large databases using the terms “computer tomography angiography” (CTA) and “magnetic resonance angiography” (MRA) and “intracranial aneurysm∗” in the article titles, abstracts, and keywords. The databases searched are PubMed-Medline, Scopus. In this meta-analysis, the initial search strategy yielded 376 relevant citations. Of these, 174 articles were retrieved for detailed evaluation and 202 were excluded. Finally, 97 articles met the rigid inclusion criteria. RESULTS: In this study, the AUC index was used to compare the difference of diagnosis value between CTA and MRA for intracranial aneurysm. We found there was no significant difference between the two methods (Z = 0.828, P> .05). The sensitivity and specificity of MRA for the identification of intracranial aneurysms over 3 mm in size is 87 to 100% and 86 to 100%, respectively, and the sensitivity and specificity of CTA for diagnosing intracranial aneurysms is 92.8 to 100% and 83 to 100%, respectively. CONCLUSION: Both imaging methods have very high and practically equal diagnostic accuracy in the detection and characterization of intracranial aneurysms (sensitivity and specificity of MRA for the identification of intracranial aneurysms over 3 mm in size is 87 to 100% and 86 to 100%, respectively, and the sensitivity and specificity of CTA for diagnosing intracranial aneurysms is 92.8 to 100% and 83 to 100%). The radiological technologist must have knowledge of the advantages and disadvantages of these two methods, in addition he must be competent in performing them and follow the latest standards based on scientific research in protocols for obtaining quality diagnostic information and apply them in agreement with radiologists