gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Three-dimensional computed tomographic angiography in the evaluation of clip placement for intracranial aneurysm

3D-Computertomographische Angiographie zur postoperativen Kontrolle bei operierten intrakraniellen Aneurysmen

Meeting Abstract

  • corresponding author I. Pechlivanis - Klinik für Neurochirurgie, Ruhr-Universität Bochum, Knappschaftskrankenhaus Bochum-Langendreer
  • D. Koenen - Klinik für Radiologie, Ruhr-Universität Bochum, Knappschaftskrankenhaus Bochum-Langendreer
  • M. Scholz - Klinik für Neurochirurgie, Ruhr-Universität Bochum, Knappschaftskrankenhaus Bochum-Langendreer
  • M. Koenig - Klinik für Radiologie, Ruhr-Universität Bochum, Knappschaftskrankenhaus Bochum-Langendreer
  • A. Harders - Klinik für Neurochirurgie, Ruhr-Universität Bochum, Knappschaftskrankenhaus Bochum-Langendreer
  • K. Schmieder - Klinik für Neurochirurgie, Ruhr-Universität Bochum, Knappschaftskrankenhaus Bochum-Langendreer

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocP 011

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2007/07dgnc266.shtml

Veröffentlicht: 11. April 2007

© 2007 Pechlivanis et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Three-dimensional computed tomographic angiography (3D-CTA) has been shown to reliably detect aneurysms preoperatively. The aim of this study was to compare the ability of 3D-CTA to detect aneurysmal remnants in connection with clip placement compared with digital subtraction angiography (DSA) postoperatively. Furthermore, special attention was paid to identifying factors influencing the image quality of 3D-CTA.

Methods: Between January 2005 and January 2006 a total of 76 patients with intracranial aneurysms were treated in our department. Thirty-two patients with a total of 33 clipped aneurysm were included in this study. All patients underwent 3D-CTA and DSA after surgery. Two investigators, each blinded to the classifications of the other, assessed image quality and clip placement.

Results: In three patients aneurysmal remnants could be detected with 3D-CTA and DSA. In one patient a 2-mm aneurysmal remnant was not clearly identified, and in two patients small (<2-mm) aneurysmal remnants were definitely not seen on 3D-CTA. One titanium clip was used for aneurysmal clipping in 26 cases, two clips were used in six cases and in one aneurysm three clips were employed. Overall, use of one titanium clip tended to result in better image quality. In addition, clip--gantry angles between 30° and 60° tended to yield better image quality.

Conclusions: Postoperatively, 3D-CTA can be recommended as a reliable non-invasive diagnostic tool only in the case of with optimal image quality. Then, up to 66% of the aneurysms can be evaluated. Titanium artefacts, especially in the important zone (<2 mm) around the clip in which small aneurysmal remnants can occur, can render adequate evaluation impossible. 3D-CTA image quality depends on the number of titanium clips used, but clip--gantry angle does not significantly influence the image quality.