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The Scientific World Journal
Volume 2014, Article ID 315960, 8 pages
http://dx.doi.org/10.1155/2014/315960
Research Article

Intravenous Flat-Detector Computed Tomography Angiography for Symptomatic Cerebral Vasospasm following Aneurysmal Subarachnoid Hemorrhage

1Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Republic of Korea
2Department of Neurosurgery, Bundang Jesaeng Hospital, Kwandong University College of Medicine, Bundang, Republic of Korea
3Department of Neurosurgery, Hallym University College of Medicine, Chuncheon, Republic of Korea

Received 29 June 2014; Revised 28 August 2014; Accepted 13 September 2014; Published 14 October 2014

Academic Editor: Robert M. Starke

Copyright © 2014 Jin Pyeong Jeon et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The study evaluated the diagnostic accuracy of intravenous flat-detector computed tomography (IV FDCT) angiography in assessing hemodynamically significant cerebral vasospasm in patients with subarachnoid hemorrhage (SAH) with digital subtraction angiography (DSA) as the reference. DSA and IV FDCT were conducted concurrently in patients suspected of having symptomatic cerebral vasospasm postoperatively. The presence and severity of vasospasm were estimated according to location (proximal versus distal). Vasospasm >50% was defined as having hemodynamic significance. Vasospasms <30% were excluded from this analysis to avoid spectrum bias. Twenty-nine patients (311 vessel segments) were measured. The intra- and interobserver agreements were excellent for depicting vasospasm ( and 0.74, resp.). IV FDCT showed a sensitivity of 95.7%, specificity of 92.3%, positive predictive value of 93.6%, and negative predictive value of 94.7% for detecting vasospasm (>50%) with DSA as the reference. Bland-Altman plots revealed good agreement of assessing vasospasm between the two tests. The discrepancy of vasospasm severity was more noted in the distal location with high-severity. However, it was not statistically significant (Spearman’s rank test; , ). Therefore, IV FDCT could be a feasible noninvasive test to evaluate suspected significant vasospasm in SAH.