Comparison of multislice computerized tomography angiography and digital subtraction angiography in the postoperative evaluation of patients with clipped aneurysms
In this study the accuracy of multislice computerized tomography (MSCT) angiography in the postoperative examination of clip-occluded intracranial aneurysms was compared with that of intraarterial digital subtraction (DS) angiography Forty-nine consecutive patients with 60 clipped aneurysms (41 of w...
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| Veröffentlicht in: | Journal of neurosurgery 2006-03, Vol.104 (3), p.395-403 |
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| creator | DEHDASHTI, Amir R BINAGHI, Stefano USKE, Antoine REGLI, Luca |
| description | In this study the accuracy of multislice computerized tomography (MSCT) angiography in the postoperative examination of clip-occluded intracranial aneurysms was compared with that of intraarterial digital subtraction (DS) angiography
Forty-nine consecutive patients with 60 clipped aneurysms (41 of which had ruptured) were studied with the aid of postoperative MSCT and DS angiography. Both types of radiological studies were reviewed independently by two observers to assess the quality of the images, the artifacts left by the clips, the completeness of aneurysm occlusion, the patency of the parent vessel, and the duration and cost of the examination. The quality of MSCT angiography was good in 42 patients (86%). Poor-quality MSCT angiograms (14%) were a result of the late acquisition of images in three patients and the presence of clip or motion artifacts in four. Occlusion of the aneurysm on good-quality MSCT angiograms was confirmed in all but two patients in whom a small (2-mm) remnant was confirmed on DS angiograms. In one patient, occlusion of a parent vessel was seen on DS angiograms but missed on MSCT angiograms. The sensitivity and specificity for detecting neck remnants on MSCT angiography were both 100%, and the sensitivity and specificity for evaluating vessel patency were 80 and 100%, respectively (95% confidence interval 29.2-100%). Interobserver agreements were 0.765 and 0.86, respectively. The mean duration of the examination was 13 minutes for MSCT angiography and 75 minutes for DS angiography (p < 0.05). Multislice CT angiography was highly cost effective (p < 0.01).
Current-generation MSCT angiography is an accurate noninvasive tool used for assessment of clipped aneurysms in the anterior circulation. Its high sensitivity and low cost warrant its use for postoperative routine control examinations following clip placement on an aneurysm. Digital subtraction angiography must be performed if the interpretation of MSCT angiograms is doubtful or if the aneurysm is located in the posterior circulation. |
| doi_str_mv | 10.3171/jns.2006.104.3.395 |
| format | Article |
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Forty-nine consecutive patients with 60 clipped aneurysms (41 of which had ruptured) were studied with the aid of postoperative MSCT and DS angiography. Both types of radiological studies were reviewed independently by two observers to assess the quality of the images, the artifacts left by the clips, the completeness of aneurysm occlusion, the patency of the parent vessel, and the duration and cost of the examination. The quality of MSCT angiography was good in 42 patients (86%). Poor-quality MSCT angiograms (14%) were a result of the late acquisition of images in three patients and the presence of clip or motion artifacts in four. Occlusion of the aneurysm on good-quality MSCT angiograms was confirmed in all but two patients in whom a small (2-mm) remnant was confirmed on DS angiograms. In one patient, occlusion of a parent vessel was seen on DS angiograms but missed on MSCT angiograms. The sensitivity and specificity for detecting neck remnants on MSCT angiography were both 100%, and the sensitivity and specificity for evaluating vessel patency were 80 and 100%, respectively (95% confidence interval 29.2-100%). Interobserver agreements were 0.765 and 0.86, respectively. The mean duration of the examination was 13 minutes for MSCT angiography and 75 minutes for DS angiography (p < 0.05). Multislice CT angiography was highly cost effective (p < 0.01).
Current-generation MSCT angiography is an accurate noninvasive tool used for assessment of clipped aneurysms in the anterior circulation. Its high sensitivity and low cost warrant its use for postoperative routine control examinations following clip placement on an aneurysm. Digital subtraction angiography must be performed if the interpretation of MSCT angiograms is doubtful or if the aneurysm is located in the posterior circulation.</description><identifier>ISSN: 0022-3085</identifier><identifier>EISSN: 1933-0693</identifier><identifier>DOI: 10.3171/jns.2006.104.3.395</identifier><identifier>PMID: 16572652</identifier><identifier>CODEN: JONSAC</identifier><language>eng</language><publisher>Park Ridge, IL: American Association of Neurological Surgeons</publisher><subject>Angiography, Digital Subtraction ; Biological and medical sciences ; Cerebral Angiography ; Female ; Humans ; Intracranial Aneurysm - diagnostic imaging ; Intracranial Aneurysm - surgery ; Male ; Medical sciences ; Neurosurgery ; Quality Control ; Reproducibility of Results ; Sensitivity and Specificity ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgical Instruments ; Tomography, X-Ray Computed ; Treatment Outcome</subject><ispartof>Journal of neurosurgery, 2006-03, Vol.104 (3), p.395-403</ispartof><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2905-57cd9ca057aaa67651640df9bf3381f35fa11b7e2d155e66152b2fb322b0a59b3</citedby><cites>FETCH-LOGICAL-c2905-57cd9ca057aaa67651640df9bf3381f35fa11b7e2d155e66152b2fb322b0a59b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17556983$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16572652$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>DEHDASHTI, Amir R</creatorcontrib><creatorcontrib>BINAGHI, Stefano</creatorcontrib><creatorcontrib>USKE, Antoine</creatorcontrib><creatorcontrib>REGLI, Luca</creatorcontrib><title>Comparison of multislice computerized tomography angiography and digital subtraction angiography in the postoperative evaluation of patients with clipped aneurysms</title><title>Journal of neurosurgery</title><addtitle>J Neurosurg</addtitle><description>In this study the accuracy of multislice computerized tomography (MSCT) angiography in the postoperative examination of clip-occluded intracranial aneurysms was compared with that of intraarterial digital subtraction (DS) angiography
Forty-nine consecutive patients with 60 clipped aneurysms (41 of which had ruptured) were studied with the aid of postoperative MSCT and DS angiography. Both types of radiological studies were reviewed independently by two observers to assess the quality of the images, the artifacts left by the clips, the completeness of aneurysm occlusion, the patency of the parent vessel, and the duration and cost of the examination. The quality of MSCT angiography was good in 42 patients (86%). Poor-quality MSCT angiograms (14%) were a result of the late acquisition of images in three patients and the presence of clip or motion artifacts in four. Occlusion of the aneurysm on good-quality MSCT angiograms was confirmed in all but two patients in whom a small (2-mm) remnant was confirmed on DS angiograms. In one patient, occlusion of a parent vessel was seen on DS angiograms but missed on MSCT angiograms. The sensitivity and specificity for detecting neck remnants on MSCT angiography were both 100%, and the sensitivity and specificity for evaluating vessel patency were 80 and 100%, respectively (95% confidence interval 29.2-100%). Interobserver agreements were 0.765 and 0.86, respectively. The mean duration of the examination was 13 minutes for MSCT angiography and 75 minutes for DS angiography (p < 0.05). Multislice CT angiography was highly cost effective (p < 0.01).
Current-generation MSCT angiography is an accurate noninvasive tool used for assessment of clipped aneurysms in the anterior circulation. Its high sensitivity and low cost warrant its use for postoperative routine control examinations following clip placement on an aneurysm. Digital subtraction angiography must be performed if the interpretation of MSCT angiograms is doubtful or if the aneurysm is located in the posterior circulation.</description><subject>Angiography, Digital Subtraction</subject><subject>Biological and medical sciences</subject><subject>Cerebral Angiography</subject><subject>Female</subject><subject>Humans</subject><subject>Intracranial Aneurysm - diagnostic imaging</subject><subject>Intracranial Aneurysm - surgery</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Neurosurgery</subject><subject>Quality Control</subject><subject>Reproducibility of Results</subject><subject>Sensitivity and Specificity</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgical Instruments</subject><subject>Tomography, X-Ray Computed</subject><subject>Treatment Outcome</subject><issn>0022-3085</issn><issn>1933-0693</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkc2OFCEURolx4rStL-DCsHF2VcNPQxVL09HRZBI3uia3KOhmQhUlUGPa1_FFZZxO2hU3cO53gYPQO0paTjt6-zDnlhEiW0p2LW-5Ei_QhirOGyIVf4k2hDDWcNKLa_Q65wdCqNxJ9gpdUyk6JgXboD_7OC2QfI4zjg5Payg-B28sNvVgLTb533bEJU7xkGA5njDMB3-pRzz6gy8QcF6HksAUX5P-Z_yMy9HiJeYSF5ug-EeL7SOEFf6xdepSKzuXjH_5csQm-GWpM2G2azrlKb9BVw5Ctm_P6xb9-Pzp-_5Lc__t7uv-431jmCKiEZ0ZlQEiOgCQnRT1tWR0anCc99Rx4YDSobNspEJYKalgA3MDZ2wgINTAt-jmOXdJ8edqc9GTz8aGUG8S16xl19Ne1Q_eIvYMmhRzTtbpJfkJ0klTop_U6KpGP6mpGzvNdVVTm96f09dhsuOl5eyiAh_OAGQDwSWYjc8XrhNCqp7zvyWmnXA</recordid><startdate>200603</startdate><enddate>200603</enddate><creator>DEHDASHTI, Amir R</creator><creator>BINAGHI, Stefano</creator><creator>USKE, Antoine</creator><creator>REGLI, Luca</creator><general>American Association of Neurological Surgeons</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200603</creationdate><title>Comparison of multislice computerized tomography angiography and digital subtraction angiography in the postoperative evaluation of patients with clipped aneurysms</title><author>DEHDASHTI, Amir R ; BINAGHI, Stefano ; USKE, Antoine ; REGLI, Luca</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2905-57cd9ca057aaa67651640df9bf3381f35fa11b7e2d155e66152b2fb322b0a59b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Angiography, Digital Subtraction</topic><topic>Biological and medical sciences</topic><topic>Cerebral Angiography</topic><topic>Female</topic><topic>Humans</topic><topic>Intracranial Aneurysm - diagnostic imaging</topic><topic>Intracranial Aneurysm - surgery</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Neurosurgery</topic><topic>Quality Control</topic><topic>Reproducibility of Results</topic><topic>Sensitivity and Specificity</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgical Instruments</topic><topic>Tomography, X-Ray Computed</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DEHDASHTI, Amir R</creatorcontrib><creatorcontrib>BINAGHI, Stefano</creatorcontrib><creatorcontrib>USKE, Antoine</creatorcontrib><creatorcontrib>REGLI, Luca</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>DEHDASHTI, Amir R</au><au>BINAGHI, Stefano</au><au>USKE, Antoine</au><au>REGLI, Luca</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of multislice computerized tomography angiography and digital subtraction angiography in the postoperative evaluation of patients with clipped aneurysms</atitle><jtitle>Journal of neurosurgery</jtitle><addtitle>J Neurosurg</addtitle><date>2006-03</date><risdate>2006</risdate><volume>104</volume><issue>3</issue><spage>395</spage><epage>403</epage><pages>395-403</pages><issn>0022-3085</issn><eissn>1933-0693</eissn><coden>JONSAC</coden><abstract>In this study the accuracy of multislice computerized tomography (MSCT) angiography in the postoperative examination of clip-occluded intracranial aneurysms was compared with that of intraarterial digital subtraction (DS) angiography
Forty-nine consecutive patients with 60 clipped aneurysms (41 of which had ruptured) were studied with the aid of postoperative MSCT and DS angiography. Both types of radiological studies were reviewed independently by two observers to assess the quality of the images, the artifacts left by the clips, the completeness of aneurysm occlusion, the patency of the parent vessel, and the duration and cost of the examination. The quality of MSCT angiography was good in 42 patients (86%). Poor-quality MSCT angiograms (14%) were a result of the late acquisition of images in three patients and the presence of clip or motion artifacts in four. Occlusion of the aneurysm on good-quality MSCT angiograms was confirmed in all but two patients in whom a small (2-mm) remnant was confirmed on DS angiograms. In one patient, occlusion of a parent vessel was seen on DS angiograms but missed on MSCT angiograms. The sensitivity and specificity for detecting neck remnants on MSCT angiography were both 100%, and the sensitivity and specificity for evaluating vessel patency were 80 and 100%, respectively (95% confidence interval 29.2-100%). Interobserver agreements were 0.765 and 0.86, respectively. The mean duration of the examination was 13 minutes for MSCT angiography and 75 minutes for DS angiography (p < 0.05). Multislice CT angiography was highly cost effective (p < 0.01).
Current-generation MSCT angiography is an accurate noninvasive tool used for assessment of clipped aneurysms in the anterior circulation. Its high sensitivity and low cost warrant its use for postoperative routine control examinations following clip placement on an aneurysm. Digital subtraction angiography must be performed if the interpretation of MSCT angiograms is doubtful or if the aneurysm is located in the posterior circulation.</abstract><cop>Park Ridge, IL</cop><pub>American Association of Neurological Surgeons</pub><pmid>16572652</pmid><doi>10.3171/jns.2006.104.3.395</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Angiography, Digital Subtraction Biological and medical sciences Cerebral Angiography Female Humans Intracranial Aneurysm - diagnostic imaging Intracranial Aneurysm - surgery Male Medical sciences Neurosurgery Quality Control Reproducibility of Results Sensitivity and Specificity Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgical Instruments Tomography, X-Ray Computed Treatment Outcome |
| title | Comparison of multislice computerized tomography angiography and digital subtraction angiography in the postoperative evaluation of patients with clipped aneurysms |
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