Preoperative localization of Adamkiewicz arteries and their origins by using MDCT angiography
Wiwithawan Sukeeyamanon1, Thanongchai Siriapisith, Jitladda Wasinrat
1Division of Diagnostic Radiology, Department of Radiology, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Objective:
To evaluate the ability of thoraco-abdominal MDCT angiography to visualize Adamkiewicz arteries for preoperative planning in patients diagnosed with aortic disease.
Material And Method:
The present study retrospectively reviewed clinical data from 73 patients who underwent a thoraco-abdominal 64-slice MDCT angiography. The Adamkiewicz artery was evaluated on multiplanar reformation images in each case. The visualization of the Adamkiewicz artery, level of origin, side of origin and continuation from an intercostal artery was investigated.
Results:
The Adamkiewicz arteries were visualized in 52 of the 73 patients (71.2%), and the total number of the delineated Adamkiewicz arteries was 64. Two Adamkiewicz arteries were found in nine patients (17.3%). Four Adamkiewicz arteries were found in one patient (1.9%). Most of the delineated arteries arose from the T9-L2 levels (89.1%). A left side of origin was found in 41 of 64 arteries (64.1%), and a right side of origin was found in 23 of 64 arteries (35.9%). Only 12 of 64 delineated arteries (18.8%) showed continuity from their origins to the anterior radiculomedullary artery.
Conclusion:
The preoperative detection rate of the Adamkiewicz artery with the routine technique of 64-slice MDCT angiography was 71.2%. The preoperative location of the Adamkiewicz artery may help to reduce the risk of perioperative ischemic changes in the spinal cord.
Insights
Thoraco-abdominal MDCT angiography visualized the Adamkiewicz artery in 71.2% of patients with aortic disease. This imaging helps identify the artery
Area of Science:
- Vascular anatomy
- Medical imaging
- Neurosurgery
Background:
- The Adamkiewicz artery is crucial for spinal cord vascularization.
- Preoperative identification of this artery is vital for patients undergoing aortic surgery.
- Aortic disease can compromise spinal cord blood supply.
Purpose of the Study:
- To assess the efficacy of thoraco-abdominal MDCT angiography in visualizing the Adamkiewicz artery.
- To evaluate the artery's origin and course for preoperative planning.
- To determine the detection rate of the Adamkiewicz artery using 64-slice MDCT angiography.
Main Methods:
- Retrospective review of 73 patients who underwent thoraco-abdominal 64-slice MDCT angiography.
- Evaluation of Adamkiewicz artery visualization, origin level, and side using multiplanar reformation.
- Analysis of the artery's continuity from its origin to the anterior radiculomedullary artery.
Main Results:
- The Adamkiewicz artery was visualized in 71.2% of patients (52/73).
- Most arteries originated from T9-L2 levels (89.1%), with a left-sided origin in 64.1%.
- Only 18.8% of visualized arteries showed continuity to the anterior radiculomedullary artery.
Conclusions:
- 64-slice MDCT angiography provides a 71.2% preoperative detection rate for the Adamkiewicz artery.
- Preoperative mapping of the Adamkiewicz artery can mitigate risks of spinal cord ischemia during surgery.
- Understanding the Adamkiewicz artery's anatomy is essential for safe aortic disease management.
