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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 28:1207-1212, August 2007
DOI 10.3174/ajnr.A0664
© 2007 American Society of Neuroradiology

Review Article

Noninvasive Imaging of Treated Cerebral Aneurysms, Part II: CT Angiographic Follow-Up of Surgically Clipped Aneurysms

R.C. Wallace^a, J.P. Karis^a, S. Partovi^a and D. Fiorella^b

^a Division of Neuroradiology, Barrow Neurological Institute, St Joseph's Hospital and Medical Center, Phoenix, Ariz
^b Sections of Neuroradiology and Neurosurgery, Cleveland Clinic, Cleveland, Ohio

Please address correspondence to David Fiorella, MD, Cleveland Clinic, Department of Neurosurgery, 9500 Euclid Ave, S80, Cleveland, OH 44195; e-mail: fioreld{at}ccf.org

SUMMARY: Although not useful for the evaluation of coiled aneurysms, CT angiography (CTA) is far superior to MR angiography (MRA) for the evaluation of aneurysms after surgical clipping. Using the latest multidetector row scanners and optimized imaging parameters, CTA can often effectively depict and follow small aneurysm remnants; demonstrate patency, stenosis, or vasospasm in the adjacent parent vessels; and provide surveillance of the entire cerebrovasculature for de novo aneurysms after surgical clipping. Despite these advances, conventional angiography remains the gold standard for the evaluation of surgically treated aneurysms and should be liberally used to resolve any cases of diagnostic uncertainty on noninvasive imaging.