Postoperative multidetector computed tomography angiography after aneurysm clipping: comparison with digital subtraction angiography.
OBJECTIVE
To evaluate the usefulness of multidetector computed tomography angiography (MDCTA) as a noninvasive diagnostic modality for the detection of aneurysm remnants after clipping of intracranial aneurysms.


METHODS
Thirty-eight patients who had aneurysm clipping and had undergone MDCTA and digital subtraction angiography (DSA) were enrolled in this study. In 16 of the 38 patients, MDCTA was performed with 16-channel MDCTA, in 20 patients with 4-channel MDCTA, and in 2 with both. Two neuroradiologists evaluated the image quality of MDCTA with a 3-point rating scale and the presence of the residual aneurysm sac with a 5-point rating scale. Receiver operating characteristic analysis was used to measure the diagnostic performance of MDCTA.


RESULTS
Forty-nine surgically clipped aneurysms were evaluated in this study. The overall diagnostic accuracy of MDCTA was 88.1% (95% confidence interval: 0.761-0.954). The ability of 16-channel MDCTA to discriminate between surgical clips and parent vessels was superior to that of 4-channel MDCTA (P=0.005).


CONCLUSIONS
Multidetector computed tomography angiography is a valuable noninvasive diagnostic modality for the assessment of aneurysm remnants in patients after aneurysm clipping.
Lee
Jeong Hyun
JH
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Kim
Sang Joon
SJ
Cha
Jihyeon
J
Kim
Hyun Jeong
HJ
Lee
Deok Hee
DH
Choi
Choong Gon
CG
Lee
Ho Kyu
HK
Suh
Dae Chul
DC
Ahn
Jae Sung
JS
D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D016477:Artifacts; D002533:Cerebral Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D012372:ROC Curve; D011856:Radiographic Image Enhancement; D013525:Surgical Instruments; D036542:Tomography, Spiral Computed / Q000379:methods*