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      Identification of the Artery of Adamkiewicz Using Multidetector Computed Tomography Angiography (MCTA) ∗

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          Abstract

          Objective  The aim of the present study is to evaluate the artery of Adamkiewicz by multidetector computed tomography angiography (MCTA) in a Brazilian population.

          Methods  Two independent observers evaluated 86 coronary MCTA examinations. The variables studied included the identification of the artery of Adamkiewicz at its origin level, and its entry side in the spine.

          Results  The artery of Adamkiewicz was detected in 71 (82.5%) examinations. The origin level was identified between the 9th and 11th thoracic vertebrae (T9 and T11) in 56 (79.2%) patients. In 65 (91.5%) patients, the artery was on the left side. The identification of the artery of Adamkiewicz using MCTA showed high reproducibility.

          Conclusions  Our results were consistent with the literature regarding the identification of the artery of Adamkiewicz using MCTA, suggesting that this technique should be considered as an option to recognize this structure. In addition, we found that the distribution of the artery of Adamkiewicz in the Brazilian population is similar to that of other populations, that is, its most common origin is at the left side, between the 8th and 12th thoracic vertebrae (T8–T12).

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          Microsurgical anatomy of the artery of Adamkiewicz and its segmental artery.

          B C Alleyne, G Shengelaia, C Michael Cawley … (1998)
          The blood supply of the lower spinal cord is heavily dependent on the artery of Adamkiewicz, which characteristically originates from one of the thoracolumbar segmental arteries. The aforementioned artery is of enormous clinical, surgical, and radiological importance, and the goal of this study was to elucidate the course and branches of the segmental artery that gives rise to this important vessel. In this cadaveric, microsurgical anatomical study, the authors investigate and describe the course and branches of the artery of Adamkiewicz and the segmental branch from which it ultimately originates. A review of the literature is provided. By documenting the microsurgical anatomy of these important vessels, this study facilitates an understanding of the anatomy that will aid in treatment planning for surgery of various lesions in this area.
          Article 0 comments Cited 21 times – based on 0 reviews     Review now
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            Improved uniformity of aortic enhancement with customized contrast medium injection protocols at CT angiography.

            D Fleischmann, G D Rubin, A A Bankier … (2000)
            To compare the uniformity of aortoiliac opacification obtained from uniphasic contrast medium injections versus individualized biphasic injections at computed tomographic (CT) angiography. Thirty-two patients with an abdominal aortic aneurysm underwent CT angiography. In 16 patients (group 1), 120 mL of contrast material was administered at a flow rate of 4 mL/sec. In the other 16 patients (group 2), biphasic injection protocols were computed by using mathematic deconvolution of each patient's time-attenuation response to a standardized test injection. Attenuation uniformity was quantified as the "plateau deviation" of enhancement values, which were calculated as the SD of the time-contiguous attenuation values observed during the 30-second scanning period. Group 2 patients received between 77 and 165 mL (mean, 115 mL) of contrast medium. Initial flow rates ranged from 4.1 to 10.0 mL/sec (mean, 6.8 mL/sec) for the first 4-6 seconds; continuing flow rates ranged from 2.0 to 4.8 mL/sec (mean, 3.1 mL/sec) for the remaining 24-26 seconds. The plateau deviation was significantly smaller in group 2 patients (19 HU) versus group 1 patients (38 HU, P <.001). At CT angiography, tailored biphasic injections led to more uniform aortoiliac enhancement, compared with standard uniphasic injections of contrast medium.
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              MR angiography and CT angiography of the artery of Adamkiewicz: state of the art.

              Takayuki Nakajima, Motoyuki Nakamura, Kohei Kawazoe … (2006)
              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.
              Article 0 comments Cited 19 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Rev Bras Ortop (Sao Paulo)
                Journal ID (iso-abbrev): Rev Bras Ortop (Sao Paulo)
                Journal ID (doi): 10.1055/s-00042410
                Title: Revista Brasileira de Ortopedia
                Publisher: Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revinter Publicações Ltda (Rio de Janeiro, Brazil )
                ISSN (Print): 0102-3616
                ISSN (Electronic): 1982-4378
                Publication date (Print): February 2020
                Publication date (Electronic): 19 December 2019
                Volume: 55
                Issue: 1
                Pages: 70-74
                Affiliations
                [1 ]Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
                [2 ]Divisão de Radiologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
                [3 ]Instituto de Radiologia Presidente Prudente, Presidente Prudente, SP, Brasil
                [4 ]Faculdade de Medicina de Botucatu, Universidade Estadual de São Paulo, Botucatu, SP, Brasil
                Author notes
                Endereço para correspondência Flávio P.F. Piola, PhD Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto Universidade de São Paulo, Avenida dos Bandeirantes, 3900, Ribeirão Preto, SP, 14048-900Brasil flaviopfpiola@ 123456gmail.com
                Author information
                http://orcid.org/0000-0001-8903-9734
                Article
                Publisher ID: 180355pt
                DOI: 10.1055/s-0039-1700829
                PMC ID: 7048565
                SO-VID: c4078f12-c4ca-454b-a3e2-c6192a01ec67
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.

                History
                Date received : 31 August 2018
                Date accepted : 16 October 2018
                Categories
                Subject: Artigo Original

                Keywords: angiography/methods,arteries/pathology,multidetector computed tomography,paraplegia,spinal cord,angiografia/métodos,artéria/patologia,tomografia computadorizada multidetectores,medula espinal
                Data availability:
                Keywords: angiography/methods, arteries/pathology, multidetector computed tomography, paraplegia, spinal cord, angiografia/métodos, artéria/patologia, tomografia computadorizada multidetectores, medula espinal

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