The value of dual-energy CTA for control of surgically clipped aneurysms

Objective Comparison of image quality in DE-CTA with and without automatic head bone removal (BR) versus CTA with 16-detectors as a tool in postoperative evaluation of patients after neurosurgical clipping. Methods In this study 30 aneurysms that had undergone neurosurgical clipping were included: 18 with DE-CTA and 12 with conventional CTA. The images were further processed using the volume rendering technique (VRT) and BR. Two experienced neuroradiologists reviewed the images regarding the severity of artefacts surrounding the clip, visibility of the vessels and remnant necks. The results were compared with DSA images, if performed. Results Significantly fewer disturbances by artefacts were observed in DE-CTA versus CTA in a 16-row system. Visibility of the surrounding vessels was satisfying in both techniques and there were comparable results with DSA with only one exception. All images produced with 140 kV provided fewer artefacts than those with 80 kV. Conclusion DE-CTA provides better image quality with fewer disturbances by clip artefact, a satisfying evaluation of remnant aneurysm necks and the surrounding vessels. As this method is easily performed and readily accessible with fast image post-processing using BR it provides an opportunity to avoid invasive DSA in the evaluation of suspected aneurysm rests.