Abstract
The role of CT-Angiography (CTA) in the diagnosis of cerebral aneurysms has not been definitively established. It depends mainly either on the low spreading of helical-CTs and on the quality of the reconstructive techniques in different equipment. Aim of this paper is to discuss certainties and controversies in the use of CTA in the diagnosis of cerebral aneurysms.
CTA can be performed in conjunction with conventional CT with minimal additional scanning time, mainly important in emergency. CTA well-defines shape, size and orientation of the aneurysm, if the scans are free of artefacts and if it is possible to well subtract bones and veins. Technology improvements are awaited in the near future to shorten the time of acquisition, increasing the volume acquired and reducing artefacts. The use of multi-array systems of acquisition, more powerful algorithms to reduce artifacts and software able to define correctly the time of injection of the contrast medium could help to reach the goal of showing all the brain arteries free of artefacts and superimposed veins. At present CTA can substitute angiography in emergency when there is no time to perform angiography and when there is CTA evidence of an aneurysm associated with local haematoma.
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