Influential Factors on the Evaluation of Adamkiewicz Artery Using a 320-Detector Row Computed Tomography Device
Alexandre C M Amato1, José R Parga Filho2, Noedir A G Stolf3
1Discipline of Thoracic and Cardiovascular Surgery, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Insights
The Adamkiewicz artery (AKA) was less frequently detected in patients with aortic disease. Atherosclerotic risk factors like smoking and hypertension also hindered AKA identification.
Area of Science:
- Vascular anatomy and imaging
- Cardiovascular disease research
- Radiology
Background:
- Understanding the Adamkiewicz artery (AKA) is crucial for aortic disease treatment planning.
- Atherosclerotic factors in aortic disease patients influence AKA presentation.
- This study investigated AKA identification using 320-detector row CT.
Purpose of the Study:
- To compare AKA presentation in healthy individuals versus those with aortic disease.
- To assess the impact of atherosclerotic risk factors on AKA detection.
- To evaluate the utility of 320-detector row CT for AKA visualization.
Main Methods:
- 115 patients underwent angio-CT scans, divided into aortic disease and control groups.
- OsiriX software and 3D multiplanar reconstruction were used for AKA identification.
- AKA origin and location were analyzed.
Main Results:
- AKA was identified in 80.3% of controls versus 42.6% of aortic disease patients (P ≤ 0.0001).
- AKA predominantly originated from the left side (73.6%) and was located at T10-T12 (70%).
- Smoking and hypertension were associated with increased odds of undetected AKA.
Conclusions:
- AKA detection rates were significantly lower in patients with aortic disease.
- Aortic disease and associated atherosclerotic risk factors impede AKA visualization.
- Advanced CT technology aids in AKA identification.
Background:
Understanding the difference of Adamkiewicz artery (AKA) presentation in healthy and diseased subjects, and the influence of atherosclerotic factors prevalent in aortic disease patients, are important for aortic disease therapeutic planning. This study used a 320-detector row computed tomography (CT) device to examine the impact of clinical aspects of AKA identification in individuals with and without aortic disease.
Methods:
Angio-CTs obtained from 115 patients were assessed and the individuals grouped according to the presence or absence of aortic disease. Datasets were analyzed using OsiriX software, and AKA was identified by three-dimensional multiplanar reconstruction.
Results:
The group without aortic disease (Group A) comprised 32 (52.5%) men and 29 women, with a mean age of 53.7 ± 16.8 years. The group with aortic disease (Group B) comprised 31 (57.4%) men and 23 women, with a mean age of 64.8 ± 11.6 years. AKA was identified in 49 (80.3%) participants of Group A and 23 (42.6%) individuals of Group B (P ≤ 0.0001). In 53 cases (73.6%), AKA originated on the left side. AKA was mainly detected on the left side (73.6%), at the level of T10 to T12 (70%). Tobacco smokers, former smokers, and hypertensive patients had increased odds of having undetected AKA.
Conclusions:
Using the method described and a state of the art 320-detector row CT device, AKA was detected more frequently among individuals without aortic disease. Thus, aortic disease and atherosclerotic risk factors hindered AKA detection.
Related Concept Videos
01:28Imaging Studies for Cardiovascular System V: CT
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:27Imaging Studies III: Computed Tomography
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
01:19Imaging Studies VII: Vascular Imaging
01:21Imaging Studies for Cardiovascular System IV: CMRI