BACKGROUND AND PURPOSE The use of 3-dimensional computed tomography angiography (3D-CTA) for clipped aneurysms is limited. Usefulness of 3D-CTA with elimination of bone and clips was evaluated in patients with clipped cerebral aneurysms. METHODS Forty-three clipped cerebral aneurysms were included. As review of digital subtraction angiography after surgery is the current gold standard, the presence or absence of remnant necks on 3D-CTA with elimination of bone and clips was compared with that on conventional CTA, using receiver operating characteristic analysis (5, definitely absent; 1, definitely present). RESULTS In the ROC analysis, the Az (.949) in CTA with clip elimination significantly (P < .05) differed from that (.751) of conventional 3D-CTA. If a score of 1 or 2 is considered to represent positive detection of remnant necks, then the sensitivity of 3D-CTA with clip elimination and of conventional 3D-CTA is 73% and 36%, respectively. If a score of 5 or 4 is considered to represent negative detection of remnant necks, then the specificity of 3D-CTA with clip elimination and of conventional 3D-CTA is 88% and 78%, respectively. CONCLUSIONS 3D-CTA with elimination of bone and clips can improve the accuracy of detection of remnant necks after clipping surgery for cerebral aneurysms.
