Value of three-dimensional CT angiography in postoperative evaluation of intracranial aneurysm clipping

Objective To assess the value of three-dimensional multislice CT angiography (CTA) in evaluating the therapeutic effect of intracranial aneurysm clipping and explore a convenient, safe and reliable method for the postoperative evaluation. Methods Of the 120 patients with intracranial aneurysms hospitalized from January, 2006 to March, 2007 in our hospital, 52 patients were treated with aneurysm clipping using titanium clips. Follow-up study for 2-38 weeks (mean 15±11weeks) was conducted in 20 of the patients with 21 aneurysms (1 patient had multiple aneurysms), including 1 in the anterior cerebral communicating artery, 7 in the posterior cerebral communicating arteries, 2 in the M3 segment of the middle cerebral arteries, 1 in the anterior choroidal artery, and 1 near the AI segment. Three-dimensional multislice CTA was performed in these patients, and the location of clips, patency of the proximal and distal segments of the parent arteries, presence of the remnant necks and domes of the aneurysms were evaluated with maximum intensity projection (MIP) and volume rendering (VR). Results The locations of 20 aneurysm clips were well visualized, and one clip was not clearly shown due to the artifacts of the clip and coils. All the proximal and distal segments of the parent arteries were clearly visualized and the relationship between the clips and the aneurysms was well demonstrated by MIP and VR in CTA. No remnant domes of the clipped aneurysms were found in these patients. Conclusion Three-dimensional multislice CTA provides an important means for postoperative evaluation of intracranial aneurysms treated with titanium clips and have great value in clinical practice. Key words: lntracranial aneurysm; CT angiography; Follow-up study