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Assessment of the anterior spinal artery and the artery of adamkiewicz using multi-detector CT angiography

Chinese Medical Journal 2009年第2期122卷 145-149页

作者： ZHAO Shao-hong, Laura Logan Pamela Schraedley Geoffrey D. Rubin Department of Radiology Chinese PLA General Hospital Beijing 100853 China Department of Radiology Stanford University Medical Center Room S-072B Stanford CA 94305-5105 USA

Background Damage to the spinal cord after the treatment of the descending thoracic and thoracoabdominal aortic aneurysms is an uncommon but devastating complication. The artery of adamkiewicz （AKA） is the principal arterial supply of the anterior spinal artery （ASA） in the lower thoracic and lumbar level. The purpose of this study was to evaluate the visualization of the anterior spinal artery and the artery of adamkiewicz, the affecting factors for the detection rate using multi-detector row CT （MDCT）. Methods Ninety-nine consecutive patients （31 women and 68 men; age range, 25-90 years; average age 61.3 years）, with suspicion for thoracic aortic lesions necessitating surgical intervention （31 aortic aneurysm, 45 dissection, 5 intramural hematoma, and 18 normal）, underwent CT angiography from the aortic arch to the aortic bifurcation. Transverse sections, multiplanar reformations and thin maximum intensity projections were used to assess the ASA and AKA. The level of the ASA and AKA origins and CT acquisition parameters were recorded. The contrast-to-noise ratio of the image, an index of the mass of the Tll body （vertebral mass index）, the subcutaneous fat thickness, and the CT value within the aortic arch and at the Tll level were measured. The detection of the ASA and AKA were evaluated relative to the acquisition parameters, scan characteristics, and aortic lesion type. Differences were assessed with the Wilcoxon rank-sum and t tests. Results The ASA was visualized in 51 patients （52%） and the AKA in 18 patients （18%）. The ASA was identified in 36/67 patients （54%） with 1.25 mm thickness and in 15/32 patients （47%） with 2.5-3.0 mm thickness. This difference did not achieve significance （P=0.13）. The detection rate of the ASA and the AKA was influenced by the vertebral mass index and the contrast-to-noise ratio （P〈0.05）. The amount of subcutaneous fat affected the detection rate of the ASA （P 〈0.05） but not the AKA. In CT scans of ASA detection, the mean CT valu

关键词： aneurysm anterior spinal artery syndrome tomography, X-ray computed angiography artery of adamkiewicz

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