Evaluation of postoperative status after clipping surgery in patients with cerebral aneurysm on 3-dimensional-CT angiography with elimination of clips.
OBJECTIVE
the use of 3-dimensional computed tomography angiography (3D-CTA) for clipped aneurysms is limited. Usefulness of 3D-CTA with elimination of bone and clips was evaluated in patients with clipped cerebral aneurysms.


METHODS
forty-three clipped cerebral aneurysms were included. As review of digital subtraction angiography after surgery is the current gold standard, the presence or absence of remnant necks on 3D-CTA with elimination of bone and clips was compared with that on conventional CTA, using receiver operating characteristic analysis (5, definitely absent; 1, definitely present).


RESULTS
in the ROC analysis, the Az (.949) in CTA with clip elimination significantly (P < .05) differed from that (.751) of conventional 3D-CTA. If a score of 1 or 2 is considered to represent positive detection of remnant necks, then the sensitivity of 3D-CTA with clip elimination and of conventional 3D-CTA is 73% and 36%, respectively. If a score of 5 or 4 is considered to represent negative detection of remnant necks, then the specificity of 3D-CTA with clip elimination and of conventional 3D-CTA is 88% and 78%, respectively.


CONCLUSIONS
3D-CTA with elimination of bone and clips can improve the accuracy of detection of remnant necks after clipping surgery for cerebral aneurysms.
Tomura
Noriaki
N
Department of Radiology, Akita University School of Medicine, Hondo, Akita City, Akita, Japan. tomura@med.akita-u.ac.jp
Sakuma
Ikuo
I
Otani
Takahiro
T
Nisii
Toshiaki
T
Sugawara
Makoto
M
Koga
Makoto
M
Takahashi
Satoshi
S
Yanagisawa
Toshiharu
T
Mizoi
Kazuo
K
D000328:Adult; D002533:Cerebral Angiography / Q000379:methods*; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery; D011184:Postoperative Period; D012372:ROC Curve; D013525:Surgical Instruments; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome