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When noncontrast computed tomography (CT) of the head identifies a subarachnoid hemorrhage, the lesion is then typically imaged with CT angiography (CTA). To summarize data on the sensitivity and specificity of CTA for diagnosing cerebral aneurysms in symptomatic patients, researchers conducted a meta-analysis of 45 methodologically rigorous studies of CTA published from January 1995 through February 2010. All 45 used either digital subtraction angiography (DSA) or neurosurgery findings as the gold standard for diagnosis.
Of the 3643 patients in these studies, 77% had a gold-standard diagnosis of cerebral aneurysm. In per-patient analyses, CTA had a pooled sensitivity of 97.2% for detecting aneurysms and a pooled specificity of 97.9% to rule…