MR angiography and CT angiography of the artery of Adamkiewicz: state of the art.
It is very important to assess the artery of Adamkiewicz before repair of the thoracoabdominal or descending thoracic aorta. Several studies have demonstrated the feasibility and advantages of noninvasive assessment of the artery of Adamkiewicz with magnetic resonance (MR) angiography and multi-detector row computed tomographic (CT) angiography. Recent advances in MR angiography and CT angiography have led to changes in the detectability of this artery. In the present study, both MR angiography and CT angiography were performed without complications for preoperative evaluation of 30 patients who underwent repair of the thoracoabdominal or descending thoracic aorta. MR angiography provided detection rates as high as 93% and 80% with the morphologic "hairpin turn" criterion and the anatomic "continuity" criterion, respectively. Sixteen-detector row CT angiography provided detection rates as high as 83% and 60%, respectively. Use of both MR angiography and CT angiography provided higher detection rates of 97% and 90%, respectively. The collateral pathways were depicted in seven cases (23%). MR angiography is superior for depiction of the artery of Adamkiewicz, especially when it arises from the false lumen of a dissecting aneurysm. CT angiography has a wide field of view and allows depiction of significant collateral pathways associated with the internal thoracic artery and intercostal arteries.
Yoshioka
Kunihiro
K
Department of Radiology, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan. kyoshi@iwate-med.ac.jp
Niinuma
Hiroyuki
H
Ehara
Shigeru
S
Nakajima
Takayuki
T
Nakamura
Motoyuki
M
Kawazoe
Kohei
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis* / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis* / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D013116:Spinal Cord / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D020760:Spinal Cord Ischemia / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014656:Vascular Surgical Procedures / Q000009:adverse effects