Postoperative assessment of clipped aneurysms with 64-slice computerized tomography angiography

Neurosurgery
Laurent ThinesRonit Agid

Abstract

Multidetector computerized tomography angiography (MDCTA) is now a widely accepted technique for the management of intracranial aneurysms. To evaluate its accuracy for the postoperative assessment of clipped intracranial aneurysms. We analyzed a consecutive series of 31 patients that underwent direct surgical clipping procedures of 38 aneurysms. A 64 slice MDCT scanner (Aquilion 64, Toshiba) was used and results were compared with digital subtraction angiographies (DSA). Two independent neuroradiologists analyzed the following data: examination quality, artifacts, aneurysm remnant, and patency of collateral branches. Interobserver agreement, sensitivity, and specificity were calculated. Seventy-nine percent of the aneurysms were located in the anterior circulation. Significant artifacts were found with multiple and cobalt-alloy clips. According to DSA, remnants >2 mm were found in 21% of the cases, and 2 patients had one collateral branch occluded. Sensitivity and specificity of 64-MDCTA for the detection of aneurysm remnants were 50% and 100%, respectively. Sensitivity and specificity of 64-MDCTA for the detection of a significant remnant (>2 mm) and the detection of the occlusion of a collateral branch were, respectively, 67%...Continue Reading

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Citations

Aug 25, 2012·Neurosurgical Review·Michaël BruneauOlivier De Witte
Oct 26, 2012·Neurosurgery·Alejandro M SpiottaShaye I Moskowitz
Oct 4, 2017·Neurosurgery·Amy LinDaniel M Mandell
Feb 21, 2019·Acta neurochirurgica·N ScheerP W A Willems

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