PURPOSE To determine whether the sensitivity and specificity of four-dimensional CTA (4D-CTA) are equivalent to digital subtraction angiography (DSA) in the detection of underlying vascular abnormalities in patients with intracerebral haemorrhage (ICH). METHODS A systematic review of studies comparing 4D-CTA with DSA in the detection of the underlying structural causes of ICH was performed on the literature published between 1998 and 2019. RESULTS We identified a total of 237 articles from PubMed, SCOPUS and Web of Science using the following Medical Subject Headings (MeSH) terms: primary intracerebral haemorrhage, 4D-CTA, DSA, cerebral haemorrhage, angiography, digital subtraction, arteriovenous malformations, 4D, CTA, dynamic-CTA and time-resolved CTA. Following the removal of duplicate publications and articles failing to meet our inclusion criteria, there were four articles potentially viable for analysis. Therefore, there were not sufficient studies to provide a statistically meaningful meta-analysis. CONCLUSION The review of current literature has demonstrated that there are few published studies comparing 4D-CTA with DSA in spontaneous ICH, with only four suitable studies identified for potential analysis. However, due to the restricted number of patients and high sensitivity and specificity of 3 studies (100%), performing a meta-analysis was not meaningful. Qualitative analysis of the data concluded that 4D-CTA has the diagnostic potential to replace invasive DSA in certain cases with vascular abnormalities. However, further research studies directly comparing 4D-CTA with DSA using larger prospective patient cohorts are required to strengthen the evidence base.

中文翻译：

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二维CT血管造影与数字减影血管造影在检测脑出血的根本原因方面是否有效：系统综述。

目的确定二维CTA（4D-CTA）的敏感性和特异性是否等同于数字减影血管造影（DSA）在检测脑出血（ICH）患者潜在的血管异常中。方法在1998年至2019年间发表的文献中，对4D-CTA与DSA进行比较以检测ICH的潜在结构性原因的研究进行了系统的综述。结果我们从PubMed，SCOPUS和Web of Science共鉴定了237篇文章，方法是以下医学主题词（MeSH）术语：原发性脑内出血，4D-CTA，DSA，脑出血，血管造影，数字减影，动静脉畸形，4D，CTA，动态CTA和时间分辨CTA。在删除了重复的出版物和不符合我们纳入标准的文章之后，有四篇文章可能进行分析。因此，没有足够的研究来提供统计学上有意义的荟萃分析。结论当前文献的回顾表明，很少有已发表的研究将4D-CTA与DSA在自发性ICH中进行比较，只有四项合适的研究可供潜在分析。但是，由于患者数量有限以及3个研究（100％）的高敏感性和特异性，进行荟萃分析没有意义。对数据的定性分析得出的结论是，在某些血管异常情况下，4D-CTA具有诊断潜力，可替代侵入性DSA。然而，