medvisМедицинская визуализацияMedical Visualization1607-07632408-9516RDS-Media Ltd.10.24835/10.24835/1607-0763-1084medvis-1084Research ArticleОТ ПРИГЛАШЕННОГО РЕДАКТОРАFROM THE INVITED EDITORРоль КТ-ангиографии в оценке лечения аневризм интракраниальных артерийThe role of CT-angiography in assessment results of surgical treatment of intracranial aneurysmshttps://orcid.org/0000-0002-6845-5613ЗябловаЕ. И.ZyablovaE. I.

Зяблова Елена Игоревна – канд. мед. наук, доцент кафедры лучевой диагностики, заведующая рентгеновским отделением

350086 Краснодар, ул. 1 Мая, д. 167

350063 Краснодар, ул. имени М. Седина, д. 4

Elena I. Zyablova – Cand. of Sci. (Med.), Senior Lecturer of Radiology Department, Kuban State Medical University; Head of Radiology Department

167, 1 Maya str., 350086, Krasnodar

4, M. Sedina str., 350063, Krasnodar

elenazyablova@inbox.ruhttps://orcid.org/0000-0003-0572-1395ПорхановВ. А.PоrkhanovV. A.

Порханов Владимир Алексеевич – академик РАН, доктор мед. наук, профессор, главный врач; заведующий кафедрой онкологии с курсом торакальной хирургии 

350086 Краснодар, ул. 1 Мая, д. 167

350063 Краснодар, ул. имени М. Седина, д. 4

Vladimir A. Pоrkhanov – Academician of the Russian Academy of Sciences, Doct. od Sci. (Med.), Professor, Chief Doctor; Head of the Department of Oncology with the Course of Thoracic Surgery 

167, 1 Maya str., 350086, Krasnodar

4, M. Sedina str., 350063, Krasnodar

kkb1@mail.ruhttps://orcid.org/0000-0002-0894-1994ФилатоваД. А.FilatovaD. A.

Филатова Дарья Андреевна – клинический ординатор кафедры лучевой диагностики и лучевой терапии

119192 Москва, Ломоносовский проспект, 27, к.10

Darya A. Filatova – Resident of Radiology and Radiotherapy Department  

27-10, Lomonosovsky prospekt, 119192, Moscow

dariafilatova.msu@mail.ruГБУЗ “Научно-исследовательский институт – Краевая клиническая больница №1 имени проф. С.В. Очаповского” Минздрава Краснодарского края; ФГБОУ ВО “Кубанский государственный медицинский университет” Минздрава РоссииРоссияThe First Regional Clinical Hospital named after S.V. Ochapovsky; Kuban State Medical UniversityRussian FederationМедицинский научно-образовательный центр ФГБОУ ВО “Московский государственный университет имени М.В. Ломоносова”РоссияMedical Research and Education Center of Lomonosov Moscow State UniversityRussian Federation2022050320222611520Copyright © Зяблова Е.И., Порханов В.А., Филатова Д.А., 20222022Зяблова Е.И., Порханов В.А., Филатова Д.А.Zyablova E.I., Pоrkhanov V.A., Filatova D.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medvis.rdsmedia.ru/jour/article/view/1084

В обзоре представлена информация о возможностях и значимости применения компьютерной томографической ангиографии (КТА) как метода послеоперационного контроля церебральных аневризм после хирургического клипирования или эндоваскулярной эмболизации. Показано сравнение диагностической ценности КТА и церебральной ангиографии в отношении рутинного послеоперационного контроля. Описаны возможности усовершенствования методик сканирования и постобработки в рамках КТА для более качественной визуализации полноты выключения аневризм, а также минимизации артефактов от хирургических клипс и катушек.

The review provides information on the possibilities and significance of computed tomography (CT) angiography as a method of postoperative control of cerebral aneurysms after treatment (surgical clipping or endovascular embolization). The comparison of the diagnostic value of CT and cerebral angiography as a routine method of postoperative control is shown. The possibilities of improving the methods of scanning and post-processing in the framework of CT angiography are described for better visualization of the completeness of aneurysm shutdown, as well as minimizing artifacts from surgical clips and coils.

компьютерная томографияКТ-ангиографиямагнитно-резонансная томографияМР-ангиографияцеребральная ангиографияаневризмаголовной мозгсубарахноидальное кровоизлияниеcomputed tomographyCT cerebral angiographymagnetic resonance imagingMR-angiographycerebral angiographyaneurysmbrainsubarachnoid hemorrhageReferencesHacein-Bey L., Provenzale J.M. Current imaging assessment and treatment of intracranial aneurysms. Am. J. Roentgenol. 2011; 196 (1): 32–44. https://doi.org/10.2214/ajr.10.5329Hacein-Bey L., Provenzale J.M. Current imaging assessment and treatment of intracranial aneurysms. Am. J. Roentgenol. 2011; 196 (1): 32–44. https://doi.org/10.2214/ajr.10.5329Johnston S.C., Dowd C.F., Higashida R.T. et al. Predictors of Rehemorrhage After Treatment of Ruptured Intracranial Aneurysms. Stroke. 2008; 39 (1): 120–125. https://doi.org/10.1161/strokeaha.107.495747Johnston S.C., Dowd C.F., Higashida R.T. et al. Predictors of Rehemorrhage After Treatment of Ruptured Intracranial Aneurysms. Stroke. 2008; 39 (1): 120–125. https://doi.org/10.1161/strokeaha.107.495747Soize S., Gawlitza M., Raoult H., Pierot L. Imaging Follow-Up of Intracranial Aneurysms Treated by Endovascular Means: Why, When, and How? Stroke. 2016: 47 (5): 1407–1412. https://doi.org/10.1161/strokeaha.115.011414Soize S., Gawlitza M., Raoult H., Pierot L. Imaging Follow-Up of Intracranial Aneurysms Treated by Endovascular Means: Why, When, and How? Stroke. 2016: 47 (5): 1407–1412. https://doi.org/10.1161/strokeaha.115.011414Vieco P.T., Morin 3rd E.E., Gross C.E. CT angiography in the examination of patients with aneurysm clips. Am. J. Neuroradiol. 1996; 17 (3): 455–457. https://doi.org/10.3174/ajnr.a1523Vieco P.T., Morin 3rd E.E., Gross C.E. CT angiography in the examination of patients with aneurysm clips. Am. J. Neuroradiol. 1996; 17 (3): 455–457. https://doi.org/10.3174/ajnr.a1523van Loon J.J., Yousry T.A., Fink U. et al. Postoperative spiral computed tomography and magnetic resonance angiography after aneurysm clipping with titanium clips. Neurosurgery. 1997; 41: 851–856. https://doi.org/10.1097/00006123-199710000-00016van Loon J.J., Yousry T.A., Fink U. et al. Postoperative spiral computed tomography and magnetic resonance angiography after aneurysm clipping with titanium clips. Neurosurgery. 1997; 41: 851–856. https://doi.org/10.1097/00006123-199710000-00016Lee J.H., Kim S.J., Cha J. et al. Postoperative multidetector computed tomography angiography after aneurysm clipping: comparison with digital subtraction angiography. J. Comput. Assist. Tomogr. 2005; 29 (1): 20–25. https://doi.org/10.1097/01.rct.0000147980.83333.d1Lee J.H., Kim S.J., Cha J. et al. Postoperative multidetector computed tomography angiography after aneurysm clipping: comparison with digital subtraction angiography. J. Comput. Assist. Tomogr. 2005; 29 (1): 20–25. https://doi.org/10.1097/01.rct.0000147980.83333.d1van der Schaaf I.C., Velthuis B.K., Wermer M.J. et al.; ASTRA Study Group. Multislice computed tomography angiography screening for new aneurysms in patients with previously clip-treated intracranial aneurysms: feasibility, positive predictive value, and interobserver agreement. J. Neurosurg. 2006; 105 (5): 682–688. https://doi.org/10.3171/jns.2006.105.5.682van der Schaaf I.C., Velthuis B.K., Wermer M.J. et al.; ASTRA Study Group. Multislice computed tomography angiography screening for new aneurysms in patients with previously clip-treated intracranial aneurysms: feasibility, positive predictive value, and interobserver agreement. J. Neurosurg. 2006; 105 (5): 682–688. https://doi.org/10.3171/jns.2006.105.5.682Wallace R.C., Karis J.P., Partovi S., Fiorella D. Noninvasive Imaging of Treated Cerebral Aneurysms, Part II: CT Angiographic Follow-Up of Surgically Clipped Aneurysms. Am. J. Neuroradiol. 2007; 28 (7): 1207–1212. https://doi.org/10.3174/ajnr.a0664Wallace R.C., Karis J.P., Partovi S., Fiorella D. Noninvasive Imaging of Treated Cerebral Aneurysms, Part II: CT Angiographic Follow-Up of Surgically Clipped Aneurysms. Am. J. Neuroradiol. 2007; 28 (7): 1207–1212. https://doi.org/10.3174/ajnr.a0664Sakuma I., Tomura N., Kinouchi H. et al. Postoperative three-dimensional CT angiography after cerebral aneurysm clipping with titanium clips: detection with single detector CT. Comparison with intra-arterial digital subtraction angiography. Clin. Radiol. 2006; 61 (6): 505–512. https://doi.org/10.1016/j.crad.2006.01.011Sakuma I., Tomura N., Kinouchi H. et al. Postoperative three-dimensional CT angiography after cerebral aneurysm clipping with titanium clips: detection with single detector CT. Comparison with intra-arterial digital subtraction angiography. Clin. Radiol. 2006; 61 (6): 505–512. https://doi.org/10.1016/j.crad.2006.01.011van der Schaaf I., van Leeuwen M., Vlassenbroek A., Velthuis B. Minimizing clip artifacts in multi CT angiography of clipped patients. Am. J. Neuroradiol. 2006; 27: 60–66.van der Schaaf I., van Leeuwen M., Vlassenbroek A., Velthuis B. Minimizing clip artifacts in multi CT angiography of clipped patients. Am. J. Neuroradiol. 2006; 27: 60–66.Dehdashti A.R., Binaghi S., Uske A., Regli L. Comparison of multislice computerized tomography angiography and digital subtraction angiography in the postoperative evaluation of patients with clipped aneurysms. J. Neurosurg. 2006; 104 (3): 395–403. https://doi.org/10.3171/jns.2006.104.3.395Dehdashti A.R., Binaghi S., Uske A., Regli L. Comparison of multislice computerized tomography angiography and digital subtraction angiography in the postoperative evaluation of patients with clipped aneurysms. J. Neurosurg. 2006; 104 (3): 395–403. https://doi.org/10.3171/jns.2006.104.3.395Bharatha A., Yeung R., Durant D. et al. Compa rison of computed tomography angiography with digital subtraction angiography in the assessment of clipped intracranial aneurysms. J. Comput. Assist. Tomogr. 2010; 34 (3): 440–445. https://doi.org/10.1097/rct.0b013e3181d27393Bharatha A., Yeung R., Durant D. et al. Compa rison of computed tomography angiography with digital subtraction angiography in the assessment of clipped intracranial aneurysms. J. Comput. Assist. Tomogr. 2010; 34 (3): 440–445. https://doi.org/10.1097/rct.0b013e3181d27393Gerardin E., Tollard E., Derrey S. et al. Usefulness of multislice computerized tomographic angiography in the post operative evaluation of patients with clipped aneurysms. Acta Neurochirurgica. 2010; 152 (5): 793– 802. https://doi.org/10.1007/s00701-009-0465-4Gerardin E., Tollard E., Derrey S. et al. Usefulness of multislice computerized tomographic angiography in the post operative evaluation of patients with clipped aneurysms. Acta Neurochirurgica. 2010; 152 (5): 793– 802. https://doi.org/10.1007/s00701-009-0465-4Dolati P., Eichberg D., Wong J.H., Goyal M. The Utility of Dual-Energy Computed Tomographic Angiography for the Evaluation of Brain Aneurysms after surgical clipping: a prospective study. Wld Neurosurg. 2015; 84 (5): 1362– 1371. https://doi.org/10.1016/j.wneu.2015.06.027Dolati P., Eichberg D., Wong J.H., Goyal M. The Utility of Dual-Energy Computed Tomographic Angiography for the Evaluation of Brain Aneurysms after surgical clipping: a prospective study. Wld Neurosurg. 2015; 84 (5): 1362– 1371. https://doi.org/10.1016/j.wneu.2015.06.027Mocanu I., Van Wettere M., Absil J. et al. Value of dualenergy CT angiography in patients with treated intracranial aneurysms. Neuroradiology. 2018; 60 (12): 1287–1295. https://doi.org/10.1007/s00234-018-2090-5Mocanu I., Van Wettere M., Absil J. et al. Value of dualenergy CT angiography in patients with treated intracranial aneurysms. Neuroradiology. 2018; 60 (12): 1287–1295. https://doi.org/10.1007/s00234-018-2090-5Winklhofer S., Hinzpeter R., Stocker D. et al. Combining monoenergetic extrapolations from dual-energy CT with iterative reconstructions: reduction of coil and clip artifacts from intracranial aneurysm therapy. Neuroradiology. 2018; 60 (3): 281–291. https://doi.org/10.1007/s00234-018-1981-9Winklhofer S., Hinzpeter R., Stocker D. et al. Combining monoenergetic extrapolations from dual-energy CT with iterative reconstructions: reduction of coil and clip artifacts from intracranial aneurysm therapy. Neuroradiology. 2018; 60 (3): 281–291. https://doi.org/10.1007/s00234-018-1981-9Wellenberg R.H.H., Hakvoort E.T., Slump C.H. et al. Metal artifact reduction techniques in musculoskeletal CT-imaging. Eur. J Radiol. 2018; 107: 60–69. https://doi.org/10.1016/j.ejrad.2018.08.010Wellenberg R.H.H., Hakvoort E.T., Slump C.H. et al. Metal artifact reduction techniques in musculoskeletal CT-imaging. Eur. J Radiol. 2018; 107: 60–69. https://doi.org/10.1016/j.ejrad.2018.08.010Wellenberg R.H., Boomsma M.F., van Osch J.A. et al. Quantifying metal artefact reduction using virtual monochromatic dual-layer detector spectral CT imaging in unilateral and bilateral total hip prostheses. Eur. J. Radiol. 2017; 88: 61–70. https://doi.org/10.1016/j. ejrad.2017.01.002Wellenberg R.H., Boomsma M.F., van Osch J.A. et al. Quantifying metal artefact reduction using virtual monochromatic dual-layer detector spectral CT imaging in unilateral and bilateral total hip prostheses. Eur. J. Radiol. 2017; 88: 61–70. https://doi.org/10.1016/j. ejrad.2017.01.002Laukamp K.R., Zopfs D., Lennartz S. et al. Metal artifacts in patients with large dental implants and bridges: combination of metal artifact reduction algorithms and virtual monoenergetic images provides an approach to handle even strongest artifacts. Eur. Radiol. 2019; 29 (8): 4228–4238. https://doi.org/10.1007/s00330-018-5928-7Laukamp K.R., Zopfs D., Lennartz S. et al. Metal artifacts in patients with large dental implants and bridges: combination of metal artifact reduction algorithms and virtual monoenergetic images provides an approach to handle even strongest artifacts. Eur. Radiol. 2019; 29 (8): 4228–4238. https://doi.org/10.1007/s00330-018-5928-7Große Hokamp N., Laukamp K.R., Lennartz S. et al. Artifact reduction from dental implants using virtual monoenergetic reconstructions from novel spectral detector CT. Eur. J. Radiol. 2018; 104: 136–142. https://doi.org/10.1016/j.ejrad.2018.04.018Große Hokamp N., Laukamp K.R., Lennartz S. et al. Artifact reduction from dental implants using virtual monoenergetic reconstructions from novel spectral detector CT. Eur. J. Radiol. 2018; 104: 136–142. https://doi.org/10.1016/j.ejrad.2018.04.018Zopfs D., Lennartz S., Pennig L. et al. Virtual monoenergetic images and post-processing algorithms effectively reduce CT artifacts from intracranial aneurysm treatment. Sci. Rep. 2020; 10: 6629. https://doi.org/10.1038/s41598-020-63574-8Zopfs D., Lennartz S., Pennig L. et al. Virtual monoenergetic images and post-processing algorithms effectively reduce CT artifacts from intracranial aneurysm treatment. Sci. Rep. 2020; 10: 6629. https://doi.org/10.1038/s41598-020-63574-8Fitsiori A., Martin S.P., Juillet De Saint Lager A. et al. Iterative Algorithms Applied to Treated Intracranial Aneurysms. Clin. Neuro radiol. 2019; 29 (4): 741–749. https://doi.org/10.1007/s00062-018-0701-5Fitsiori A., Martin S.P., Juillet De Saint Lager A. et al. Iterative Algorithms Applied to Treated Intracranial Aneurysms. Clin. Neuro radiol. 2019; 29 (4): 741–749. https://doi.org/10.1007/s00062-018-0701-5Pjontek R., Önenköprülü B., Scholz B. et al. Metal artifact reduction for flat panel detector intravenous CT angiography in patients with intracranial metallic implants after endovascular and surgical treatment. J. Neurointervent. Surg. 2016; 8 (8): 824–829. https://doi.org/10.1136/neurintsurg-2015-011787Pjontek R., Önenköprülü B., Scholz B. et al. Metal artifact reduction for flat panel detector intravenous CT angiography in patients with intracranial metallic implants after endovascular and surgical treatment. J. Neurointervent. Surg. 2016; 8 (8): 824–829. https://doi.org/10.1136/neurintsurg-2015-011787Prell D., Kyriakou Y., Struffert T. et al. Metal artifact reduction for clipping and coiling in interventional C-arm CT. Am. J. Neuroradiol. 2010; 31 (4): 634–639. https://doi.org/10.3174/ajnr.A1883Prell D., Kyriakou Y., Struffert T. et al. Metal artifact reduction for clipping and coiling in interventional C-arm CT. Am. J. Neuroradiol. 2010; 31 (4): 634–639. https://doi.org/10.3174/ajnr.A1883Psychogios M.N., Scholz B., Rohkohl C. et al. Impact of a new metal artefact reduction algorithm in the noninvasive follow-up of intracranial clips, coils, and stents with flatpanel angiographic CTA: initial results. Neuroradiology. 2013; 55 (7): 813–818. https://doi.org/10.1007/s00234-013-1165-6Psychogios M.N., Scholz B., Rohkohl C. et al. Impact of a new metal artefact reduction algorithm in the noninvasive follow-up of intracranial clips, coils, and stents with flatpanel angiographic CTA: initial results. Neuroradiology. 2013; 55 (7): 813–818. https://doi.org/10.1007/s00234-013-1165-6Chintalapani G., Chinnadurai P., Srinivasan V. et al. Evaluation of C-arm CT metal artifact reduction algorithm during intra-aneurysmal coil embolization: assessment of brain parenchyma, stents and flow-diverters. Eur. J. Radiol. 2016; 85 (7): 1312–1321. https://doi.org/10.1016/j.ejrad.2016.04.013Chintalapani G., Chinnadurai P., Srinivasan V. et al. Evaluation of C-arm CT metal artifact reduction algorithm during intra-aneurysmal coil embolization: assessment of brain parenchyma, stents and flow-diverters. Eur. J. Radiol. 2016; 85 (7): 1312–1321. https://doi.org/10.1016/j.ejrad.2016.04.013Pan Y.N., Chen G., Li A.J. et al. Reduction of metallic artifacts of the post-treatment intracranial aneurysms: effects of single energy metal artifact reduction algorithm. Clin. Neuro radiol. 2019; 29 (2): 277–284. https://doi.org/10.1007/s00062-017-0644-2Pan Y.N., Chen G., Li A.J. et al. Reduction of metallic artifacts of the post-treatment intracranial aneurysms: effects of single energy metal artifact reduction algorithm. Clin. Neuro radiol. 2019; 29 (2): 277–284. https://doi.org/10.1007/s00062-017-0644-2

The authors declare that there are no conflicts of interest present.