ROLE OF CT AND MRI IN EVALUATION OF INTRACRANIAL ANEURYSM: A HOSPITAL-BASED PROSPECTIVE CROSS-SECTIONAL DIAGNOSTIC STUDY
DOI:
https://doi.org/10.51168/qv6jj571Keywords:
Intracranial aneurysm, CT angiography, MR angiography, digital subtraction angiography,, subarachnoid haemorrhage, saccular aneurysm, diagnostic accuracyAbstract
Introduction: To compare the diagnostic performance of computed tomography (CT) and magnetic resonance imaging (MRI), individually and in combination, in detecting, characterising and evaluating intracranial aneurysms.
Materials and Methods: This hospital-based prospective cross-sectional study was carried out in the Department of Radiodiagnosis, Katihar Medical College and Hospital, Katihar, over two and a half years. Fifty consecutive patients with suspected or known intracranial aneurysm underwent CT angiography (16-slice multidetector scanner) and MR angiography (1.5 Tesla), with digital subtraction angiography (DSA) as the reference standard. Data were analysed in SPSS using descriptive statistics, the chi-square test and yield analysis.
Results: The mean age was 43.42 ± 11.64 years, 58% of patients were male and 60% were from semi-urban areas. Cranial nerve palsy (36%) was the commonest presentation, followed by subarachnoid haemorrhage (30%). CT detected aneurysms in 40 of 50 patients (sensitivity 80%) and MRI in 47 of 50 (sensitivity 94%); DSA confirmed aneurysms in all 50. The middle cerebral artery (34%) and anterior communicating artery (22%) were the commonest sites. Saccular and fusiform aneurysms each accounted for 36% of cases, and 52% had ruptured at presentation. Detection by either modality was not significantly associated with aneurysm size or morphology, and rupture was not significantly associated with risk factors (all p > 0.05).
Conclusion: MRI showed higher sensitivity and diagnostic accuracy than CT, particularly for small lesions, while CT remained valuable for rapid assessment in emergencies. A combined approach gives the most comprehensive evaluation.
Recommendation: CT angiography is suggested as the first-line investigation in acute presentations, with MR angiography added in stable patients, when CT is negative or equivocal, and for detailed characterisation. Larger multicentre studies that include aneurysm-negative patients are needed.
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