Diagnostic Yield of Catheter Angiography in Patients with Subarachnoid Hemorrhage and Negative Initial Noninvasive Neurovascular Examinations
| Autor: | B Crandall, Yasha Kadkhodayan, Jill M Scholz, David E Tubman, Jennifer L Fease, J Delgado Almandoz, R Anderson |
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| Rok vydání: | 2012 |
| Předmět: |
medicine.medical_specialty
Subarachnoid hemorrhage Interventional medicine.diagnostic_test business.industry Retrospective cohort study Magnetic resonance imaging Neurovascular bundle medicine.disease nervous system diseases Peripheral Catheter Cohort medicine Radiology Nuclear Medicine and imaging cardiovascular diseases Neurology (clinical) Radiology business Cerebral angiography |
| Zdroj: | AJNR Am J Neuroradiol |
| ISSN: | 1936-959X 0195-6108 |
| Popis: | BACKGROUND AND PURPOSE: The yield of DSA in patients with SAH and negative initial noninvasive neurovascular examinations (CTA or MRA) is not well-understood. This study aimed to determine the yield of DSA for the detection of causative vascular lesions in this clinical scenario. MATERIALS AND METHODS: We examined the yield of DSA for the detection of causative vascular lesions in a cohort of patients presenting to our institution with SAH and negative initial noninvasive neurovascular examinations during a 5-year period. Two experienced neuroradiologists independently evaluated the NCCT to determine the SAH pattern (diffuse, perimesencephalic, or peripheral sulcal) and the catheter angiograms to assess the presence of a causative vascular lesion. RESULTS: Fifty-five patients were included in the study, with a mean age of 58.2 years (median, 58 years; range, 25–88 years). Twenty-eight patients were men (50.9%), and 27 were women (49.1%). The initial noninvasive examination was a CTA in 47 patients (85.5%) and an MRA in 8 patients (14.5%). Thirty-three patients had diffuse SAH (60%); 11, perimesencephalic SAH (20%); and 11, peripheral sulcal SAH (20%). DSA demonstrated a causative vascular lesion in 6 patients (10.9%), 5 of whom had diffuse SAH (yield of 15.2%) and 1 of whom had peripheral sulcal SAH (yield of 9.1%). No causative vascular lesions were found in patients with perimesencephalic SAH. CONCLUSIONS: DSA is a valuable tool in the evaluation of patients with diffuse and peripheral sulcal SAH who have negative initial noninvasive neurovascular examinations, demonstrating a causative vascular lesion in 15.2% and 9.1% of patients, respectively. |
| Databáze: | OpenAIRE |
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