Accuracy of CT angiography for the diagnosis of vascular abnormalities causing intraparenchymal hemorrhage in young patients

Javier M. Romero, Maddy Artunduaga, N. Paola Forero, Josser Delgado, Kiran Sarfaraz, Joshua N. Goldstein, R. Gilberto Gonzalez, Pamela W. Schaefer

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

The objective of this study is to measure the accuracy of multidetector CT angiography (MD CTA) in the detection of vascular abnormalities in patients ≤40 years with spontaneous intraparenchymal hemorrhage (IPH) presenting to the emergency department. After institutional review board approval, a retrospective study was performed of 43 consecutive patients ≤40 years, who presented to our emergency department with IPH and that were evaluated with MD CTA. MD CTA images were reviewed by a neuroradiologist to determine IPH location, presence of a vascular abnormality, and associated extraparenchymal hemorrhage. Diagnostic accuracy was measured comparing it to the available reference standards, which included conventional catheter angiogram (CCA), surgical macroscopic findings, and pathology results. Medical records were reviewed for risk factors and correlation with final diagnosis. MD CTA demonstrated an accuracy of 97.7%, with a sensitivity of 96.4% (95% CI 0.79-0.99) and a specificity of 100% (95% CI 0.74-0.99) for the detection of vascular abnormalities in young patients with IPH. Additionally, MD CTA had a PPV of 100%, and the NPV 93.8% in this population. Of the 43 patients included in the study, 28 patients (65%) had a causative vascular etiology for the IPH. Among the 28 patients with vascular etiologies for the IPH, 11 had an AVM (39.2%), nine a ruptured aneurysm (32.14%), seven dural venous sinus thrombosis (25%), and one had vasculitis (3.57%). MD CTA is highly accurate in the detection of vascular abnormalities in the setting of IPH, which as a group represents the most frequent etiology of IPH among patients age ≤40 years. MD CTA performed in the Emergency Department provides accurate, rapid and critical presurgical and premedical treatment information in young patients with IPH.

Original languageEnglish (US)
Pages (from-to)195-201
Number of pages7
JournalEmergency Radiology
Volume16
Issue number3
DOIs
StatePublished - May 1 2009
Externally publishedYes

Fingerprint

Blood Vessels
Hemorrhage
Hospital Emergency Service
Computed Tomography Angiography
Intracranial Sinus Thrombosis
Ruptured Aneurysm
Research Ethics Committees
Vasculitis
Venous Thrombosis
Medical Records
Angiography
Catheters
Retrospective Studies
Pathology
Population

Keywords

  • Accuracy
  • Angiography
  • CTA
  • MD CTA
  • Neuroradiology
  • STROKE
  • Young

ASJC Scopus subject areas

  • Emergency Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Accuracy of CT angiography for the diagnosis of vascular abnormalities causing intraparenchymal hemorrhage in young patients. / Romero, Javier M.; Artunduaga, Maddy; Forero, N. Paola; Delgado, Josser; Sarfaraz, Kiran; Goldstein, Joshua N.; Gonzalez, R. Gilberto; Schaefer, Pamela W.

In: Emergency Radiology, Vol. 16, No. 3, 01.05.2009, p. 195-201.

Research output: Contribution to journalArticle

Romero, JM, Artunduaga, M, Forero, NP, Delgado, J, Sarfaraz, K, Goldstein, JN, Gonzalez, RG & Schaefer, PW 2009, 'Accuracy of CT angiography for the diagnosis of vascular abnormalities causing intraparenchymal hemorrhage in young patients', Emergency Radiology, vol. 16, no. 3, pp. 195-201. https://doi.org/10.1007/s10140-008-0785-3
Romero, Javier M. ; Artunduaga, Maddy ; Forero, N. Paola ; Delgado, Josser ; Sarfaraz, Kiran ; Goldstein, Joshua N. ; Gonzalez, R. Gilberto ; Schaefer, Pamela W. / Accuracy of CT angiography for the diagnosis of vascular abnormalities causing intraparenchymal hemorrhage in young patients. In: Emergency Radiology. 2009 ; Vol. 16, No. 3. pp. 195-201.
@article{0e1d89ca74ac4b29909c84b4970881cd,
title = "Accuracy of CT angiography for the diagnosis of vascular abnormalities causing intraparenchymal hemorrhage in young patients",
abstract = "The objective of this study is to measure the accuracy of multidetector CT angiography (MD CTA) in the detection of vascular abnormalities in patients ≤40 years with spontaneous intraparenchymal hemorrhage (IPH) presenting to the emergency department. After institutional review board approval, a retrospective study was performed of 43 consecutive patients ≤40 years, who presented to our emergency department with IPH and that were evaluated with MD CTA. MD CTA images were reviewed by a neuroradiologist to determine IPH location, presence of a vascular abnormality, and associated extraparenchymal hemorrhage. Diagnostic accuracy was measured comparing it to the available reference standards, which included conventional catheter angiogram (CCA), surgical macroscopic findings, and pathology results. Medical records were reviewed for risk factors and correlation with final diagnosis. MD CTA demonstrated an accuracy of 97.7{\%}, with a sensitivity of 96.4{\%} (95{\%} CI 0.79-0.99) and a specificity of 100{\%} (95{\%} CI 0.74-0.99) for the detection of vascular abnormalities in young patients with IPH. Additionally, MD CTA had a PPV of 100{\%}, and the NPV 93.8{\%} in this population. Of the 43 patients included in the study, 28 patients (65{\%}) had a causative vascular etiology for the IPH. Among the 28 patients with vascular etiologies for the IPH, 11 had an AVM (39.2{\%}), nine a ruptured aneurysm (32.14{\%}), seven dural venous sinus thrombosis (25{\%}), and one had vasculitis (3.57{\%}). MD CTA is highly accurate in the detection of vascular abnormalities in the setting of IPH, which as a group represents the most frequent etiology of IPH among patients age ≤40 years. MD CTA performed in the Emergency Department provides accurate, rapid and critical presurgical and premedical treatment information in young patients with IPH.",
keywords = "Accuracy, Angiography, CTA, MD CTA, Neuroradiology, STROKE, Young",
author = "Romero, {Javier M.} and Maddy Artunduaga and Forero, {N. Paola} and Josser Delgado and Kiran Sarfaraz and Goldstein, {Joshua N.} and Gonzalez, {R. Gilberto} and Schaefer, {Pamela W.}",
year = "2009",
month = "5",
day = "1",
doi = "10.1007/s10140-008-0785-3",
language = "English (US)",
volume = "16",
pages = "195--201",
journal = "Emergency Radiology",
issn = "1070-3004",
publisher = "Springer New York",
number = "3",

}

TY - JOUR

T1 - Accuracy of CT angiography for the diagnosis of vascular abnormalities causing intraparenchymal hemorrhage in young patients

AU - Romero, Javier M.

AU - Artunduaga, Maddy

AU - Forero, N. Paola

AU - Delgado, Josser

AU - Sarfaraz, Kiran

AU - Goldstein, Joshua N.

AU - Gonzalez, R. Gilberto

AU - Schaefer, Pamela W.

PY - 2009/5/1

Y1 - 2009/5/1

N2 - The objective of this study is to measure the accuracy of multidetector CT angiography (MD CTA) in the detection of vascular abnormalities in patients ≤40 years with spontaneous intraparenchymal hemorrhage (IPH) presenting to the emergency department. After institutional review board approval, a retrospective study was performed of 43 consecutive patients ≤40 years, who presented to our emergency department with IPH and that were evaluated with MD CTA. MD CTA images were reviewed by a neuroradiologist to determine IPH location, presence of a vascular abnormality, and associated extraparenchymal hemorrhage. Diagnostic accuracy was measured comparing it to the available reference standards, which included conventional catheter angiogram (CCA), surgical macroscopic findings, and pathology results. Medical records were reviewed for risk factors and correlation with final diagnosis. MD CTA demonstrated an accuracy of 97.7%, with a sensitivity of 96.4% (95% CI 0.79-0.99) and a specificity of 100% (95% CI 0.74-0.99) for the detection of vascular abnormalities in young patients with IPH. Additionally, MD CTA had a PPV of 100%, and the NPV 93.8% in this population. Of the 43 patients included in the study, 28 patients (65%) had a causative vascular etiology for the IPH. Among the 28 patients with vascular etiologies for the IPH, 11 had an AVM (39.2%), nine a ruptured aneurysm (32.14%), seven dural venous sinus thrombosis (25%), and one had vasculitis (3.57%). MD CTA is highly accurate in the detection of vascular abnormalities in the setting of IPH, which as a group represents the most frequent etiology of IPH among patients age ≤40 years. MD CTA performed in the Emergency Department provides accurate, rapid and critical presurgical and premedical treatment information in young patients with IPH.

AB - The objective of this study is to measure the accuracy of multidetector CT angiography (MD CTA) in the detection of vascular abnormalities in patients ≤40 years with spontaneous intraparenchymal hemorrhage (IPH) presenting to the emergency department. After institutional review board approval, a retrospective study was performed of 43 consecutive patients ≤40 years, who presented to our emergency department with IPH and that were evaluated with MD CTA. MD CTA images were reviewed by a neuroradiologist to determine IPH location, presence of a vascular abnormality, and associated extraparenchymal hemorrhage. Diagnostic accuracy was measured comparing it to the available reference standards, which included conventional catheter angiogram (CCA), surgical macroscopic findings, and pathology results. Medical records were reviewed for risk factors and correlation with final diagnosis. MD CTA demonstrated an accuracy of 97.7%, with a sensitivity of 96.4% (95% CI 0.79-0.99) and a specificity of 100% (95% CI 0.74-0.99) for the detection of vascular abnormalities in young patients with IPH. Additionally, MD CTA had a PPV of 100%, and the NPV 93.8% in this population. Of the 43 patients included in the study, 28 patients (65%) had a causative vascular etiology for the IPH. Among the 28 patients with vascular etiologies for the IPH, 11 had an AVM (39.2%), nine a ruptured aneurysm (32.14%), seven dural venous sinus thrombosis (25%), and one had vasculitis (3.57%). MD CTA is highly accurate in the detection of vascular abnormalities in the setting of IPH, which as a group represents the most frequent etiology of IPH among patients age ≤40 years. MD CTA performed in the Emergency Department provides accurate, rapid and critical presurgical and premedical treatment information in young patients with IPH.

KW - Accuracy

KW - Angiography

KW - CTA

KW - MD CTA

KW - Neuroradiology

KW - STROKE

KW - Young

UR - http://www.scopus.com/inward/record.url?scp=64249136057&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=64249136057&partnerID=8YFLogxK

U2 - 10.1007/s10140-008-0785-3

DO - 10.1007/s10140-008-0785-3

M3 - Article

C2 - 19132425

AN - SCOPUS:64249136057

VL - 16

SP - 195

EP - 201

JO - Emergency Radiology

JF - Emergency Radiology

SN - 1070-3004

IS - 3

ER -