Digital Subtraction Angiography (DSA) has been considered as a Gold standard for blood vessels imaging. What about magnetic resonance angiography (MRA) and Computed Tomography Angiography (CTA)?
For very small aneurysms DSA is superior in performance, specially in SAH patients with negative CTA. CTA has excellent accuracy (sens and spec) in not small aneurysms (>3-4 mm). MRA can be useful in follow up.
Thank you for answering,
Can we say that DSA is the first choice for diagnosis and treatment ??
Digital substraction angiography is the best and gold standard for management of aneurysmal bleed. In centres where the facility is not available, CT angiography can be equally effective, and gives a detailed account of bony landmarks in relation to the aneurysm as well.
DSA is the best but for more precise study of relation between aneurysmal neck and parent vessel 3D rotational DSA is the standard one
Firstly neck and cerebral CTA. Then planning for dignosis and treatment. Finally cerebral 3D DSA and treatment.
For screening untreated aneurysms, 3T MRA
To clear doubt between vessel loop and very small aneurysms, final statement made on DSA
To control treated patients, DSA more precise than MRA specially to appreciate a stent. Combination DSA and MR required for flow diverters
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