Identifying the Adamkiewicz artery using 3-T time-resolved magnetic resonance angiography: its role in addition to multidetector computed tomography angiography.
OBJECTIVE
This study assessed Adamkiewicz artery (AKA) detectability using multidetector computed tomography angiography (MDCTA) and time-resolved magnetic resonance angiography (MRA) at 3 T.


METHODS
This Institutional Review Board-approved retrospective study included 117 patients with thoracoabdominal aortic disease scheduled for aortic repair. A total of 111 patients underwent MDCTA for AKA identification; 43 patients whose AKA identification was not definitive on MDCTA underwent additional MRA. The remaining six patients, who were not indicated for iodine-contrast MDCTA, underwent only MRA. Two reviewers independently evaluated both MDCTA and MRA data. The 4-point confidence index was used. Grades 3-4 were considered sufficient for AKA diagnosis.


RESULTS
AKA detectability was at 80.2% (89/111) using MDCTA and 89.8% (44/49) with MRA. In the 43 patients who underwent both MDTCA and MRA, the AKA detectability and consensus grades were significantly elevated using MRA vs. MDCTA (detectability: 88.4 vs. 69.8%, respectively, p = 0.043). AKA detectability was also higher in aortic aneurysm than aortic dissection patients on MDCTA (90.9 vs. 69.6%, respectively, p < 0.01), but not on MRA (92.9 vs. 88.6%, respectively, p = 0.99).


CONCLUSIONS
Time-resolved MRA at 3 T increases AKA detectability and is recommended for patients without definitive AKA identification on MDCTA.
Department of Diagnostic Radiology, Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
Hidenobu
H
Takagi
Department of Diagnostic Radiology, Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan. h-ota@rad.med.tohoku.ac.jp.
Hideki
H
Ota
Siemens Medical Solutions USA, 10945, Le Conte Ave, Suite 3371, Los Angeles, CA, 90095-7206, USA.
Yutaka
Y
Natsuaki
Research and Collaboration Department, Imaging and Therapy Systems Division, Siemens Japan K.K., 1-11-1, Osaki, Shinagawa-ku, Tokyo, 141-8644, Japan.
Yoshiaki
Y
Komori
Division of Cardiovascular Surgery, Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
Koki
K
Ito
Division of Cardiovascular Surgery, Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
Yoshikatsu
Y
Saiki
Department of Diagnostic Radiology, Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
Kei
K
Takase
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods; D001158:Arteries / Q000473:pathology; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D012189:Retrospective Studies; D013116:Spinal Cord / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D055815:Young Adult
Adamkiewicz artery; Multidetector computed tomography angiography; Thoracic aortic aneurysm; Thoracoabdominal aortic aneurysm; Time-resolved magnetic resonance angiography at 3 T