Postoperative three-dimensional CT angiography after cerebral aneurysm clipping with titanium clips: detection with single detector CT. Comparison with intra-arterial digital subtraction angiography

Clin Radiol. 2006 Jun;61(6):505-12. doi: 10.1016/j.crad.2006.01.011.

Abstract

Aim: To assess the significance of three-dimensional computed tomography angiography (3D-CTA) in detecting remnant necks after cerebral aneurysm clipping.

Materials and methods: A total of 59 patients (77 aneurysms) underwent surgery using titanium clips. Two blinded observers independently evaluated the presence of neck remnants on shaded-surface display (SSD) imaging, volume rendered (VR) imaging, and intra-arterial digital subtraction angiography (IADSA).

Results: Mean sensitivity and specificity for detecting neck remnants were 50.0 and 74.2% for SSD imaging, 61.5 and 82.8% for VR imaging, and 92.3 and 92.2% for IADSA, respectively. Receiver operating characteristic (ROC) analysis revealed excellent diagnostic performance for IADSA [mean area under ROC curve (Az)=0.97], and good diagnostic performance for 3D-CTA (Az=0.70 and 0.76 for SSD and VR, respectively). Specificity of VR was better than that SSD (p=0.082), however, there was no significant difference between them.

Conclusion: Use of 3D-CTA techniques can facilitate postoperative evaluation.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Angiography, Digital Subtraction / methods
  • Angiography, Digital Subtraction / standards
  • Cerebral Angiography / methods
  • Cerebral Angiography / standards
  • Female
  • Humans
  • Imaging, Three-Dimensional
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / surgery*
  • Male
  • Middle Aged
  • Observer Variation
  • Postoperative Care
  • Sensitivity and Specificity
  • Surgical Instruments*
  • Tomography, Spiral Computed / methods
  • Tomography, Spiral Computed / standards