title: Efficacy of skull plain films in follow-up evaluation of cerebral aneurysms treated with detachable coils: quantitative assessment of coil mass.
abstract: OBJECTIVE
  Skull plain films of coiled aneurysms have been used in a limited role, including morphologic comparison of the coil mass. We aimed to evaluate the efficacy of skull plain films in patients treated with detachable coils by using quantitative assessment.
  
  
  METHODS
  In this retrospective study, 78 pairs of the initial and follow-up skull anteroposterior and lateral images were reviewed independently by 2 neuroradiologists. The largest diameter, the perpendicular diameter, and area of the coil mass were measured separately on plain film, and quantitative changes of parameters were compared between subgroups, which were determined by consensus, depending on the need for retreatment. Subgroup analysis was also performed according to aneurysm size, packing attenuation, and ruptured status.
  
  
  RESULTS
  On skull lateral images, mean quantitative changes of the largest diameter (0.53 ± 0.43 mm versus 1.17 ± 0.91 mm, P < .01), the perpendicular diameter (0.56 ± 0.48 mm versus 1.20 ± 1.05 mm, P < .01), and the area of the coil mass (5.21 ± 7.51 mm(2) versus 10.55 ± 10.93 mm(2), P < .02) differed significantly between subgroups. Receiver operating characteristic analysis showed quantitative change of the largest diameter (>1.1 mm; sensitivity, 50.0%; specificity, 90.3%), the perpendicular diameter (>.9 mm; sensitivity, 62.5%; specificity, 85.5%), and the area (>8.5 mm(2); sensitivity, 50.0%; specificity, 83.9%) on skull lateral films to be indicative of aneurysm recurrence, and the diagnostic accuracy of these parameters increased significantly in the high-packing-attenuation group.
  
  
  CONCLUSIONS
  Quantitative measurement of the coil mass by using skull plain lateral images has the potential to predict aneurysm recurrence in follow-up evaluations of intracranial aneurysms with coiling.
authors.affiliation: From the Department of Radiology (S.J.A., W.S.J., S.H.S.), Gangnam Severance Hospital.
authors.forename: S J
authors.initials: SJ
authors.lastname: Ahn
authors.affiliation: Department of Radiology (B.M.K.).
authors.forename: B M
authors.initials: BM
authors.lastname: Kim
authors.affiliation: From the Department of Radiology (S.J.A., W.S.J., S.H.S.), Gangnam Severance Hospital.
authors.forename: W S
authors.initials: WS
authors.lastname: Jung
authors.affiliation: From the Department of Radiology (S.J.A., W.S.J., S.H.S.), Gangnam Severance Hospital Severance Institute of Vascular and Metabolic Research (S.H.S.), Yonsei University College of Medicine, Seoul, Korea. SUHSH11@yuhs.ac.
authors.forename: S H
authors.initials: SH
authors.lastname: Suh
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D002533:Cerebral Angiography / Q000295:instrumentation; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012008:Recurrence; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012886:Skull / Q000000981:diagnostic imaging*