Postoperative three-dimensional CT angiography after cerebral aneurysm clipping with titanium clips: detection with single detector CT. Comparison with intra-arterial digital subtraction angiography.
OBJECTIVE
To assess the significance of three-dimensional computed tomography angiography (3D-CTA) in detecting remnant necks after cerebral aneurysm clipping.


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.


CONCLUSIONS
Use of 3D-CTA techniques can facilitate postoperative evaluation.
Sakuma
I
I
Division of Radiology, Department of Integrated Medicine, Akita University School of Medicine, Akita 010-8543, Japan. sakuma@doc.med.akita-u.ac.jp
Tomura
N
N
Kinouchi
H
H
Takahashi
S
S
Otani
T
T
Watarai
J
J
Mizoi
K
K
D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods / Q000592:standards; D002533:Cerebral Angiography / Q000379:methods / Q000592:standards; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011182:Postoperative Care; D012680:Sensitivity and Specificity; D013525:Surgical Instruments; D036542:Tomography, Spiral Computed / Q000379:methods / Q000592:standards