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Identification of the Artery of Adamkiewicz Using Multidetector Computed Tomography Angiography (MCTA)[∗]Article in several languages: português | English
31 August 2018
16 October 2018
19 December 2019 (online)
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).
Keywordsangiography/methods - arteries/pathology - multidetector computed tomography - paraplegia - spinal cord
∗ Work developed at the Biomechanics Department, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
- 1 Kieffer E, Fukui S, Chiras J, Koskas F, Bahnini A, Cormier E. Spinal cord arteriography: a safe adjunct before descending thoracic or thoracoabdominal aortic aneurysmectomy. J Vasc Surg 2002; 35 (02) 262-268
- 2 Schepens M, Dossche K, Morshuis W. , et al. Introduction of adjuncts and their influence on changing results in 402 consecutive thoracoabdominal aortic aneurysm repairs. Eur J Cardiothorac Surg 2004; 25 (05) 701-707
- 3 Puertas EB, Chagas JC, Oliveira CA, Wajchenberg M, Santos FP, Oliveira VM. Complicações neurológicas no tratamento da escoliose idiopática com instrumentação e artrodese por via posterior. Acta Ortop Bras 1998; 6 (04) 168-172
- 4 Adamkiewicz A. Die blutgefäße des menschlichen rückenmarkes. I theil, SitzungsBerichte der Kaiserlichen Akademie der Wissenschaften Mathematisch-Naturwissenschaftliche. Classe 1881; 84: 469-502
- 5 Alleyne Jr CH, Cawley CM, Shengelaia GG, Barrow DL. Microsurgical anatomy of the artery of Adamkiewicz and its segmental artery. J Neurosurg 1998; 89 (05) 791-795
- 6 Standring S. Gray's anatomy: the anatomical basis of clinical practice. 40th ed. Edinburgh: Churchill Livingstone; 2008
- 7 Heinemann MK, Brassel F, Herzog T, Dresler C, Becker H, Borst HG. The role of spinal angiography in operations on the thoracic aorta: myth or reality?. Ann Thorac Surg 1998; 65 (02) 346-351
- 8 Takase K, Sawamura Y, Igarashi K. , et al. Demonstration of the artery of Adamkiewicz at multi- detector row helical CT. Radiology 2002; 223 (01) 39-45
- 9 Kudo K, Terae S, Asano T. , et al. Anterior spinal artery and artery of Adamkiewicz detected by using multi-detector row CT. AJNR Am J Neuroradiol 2003; 24 (01) 13-17
- 10 Yoshioka K, Niinuma H, Ohira A. , et al. MR angiography and CT angiography of the artery of Adamkiewicz: noninvasive preoperative assessment of thoracoabdominal aortic aneurysm. Radiographics 2003; 23 (05) 1215-1225
- 11 Nakayama Y, Awai K, Yanaga Y. , et al. Optimal contrast medium injection protocols for the depiction of the Adamkiewicz artery using 64-detector CT angiography. Clin Radiol 2008; 63 (08) 880-887
- 12 Uotani K, Yamada N, Kono AK. , et al. Preoperative visualization of the artery of Adamkiewicz by intra-arterial CT angiography. AJNR Am J Neuroradiol 2008; 29 (02) 314-318
- 13 Fanous AA, Lipinski LJ, Krishna C. , et al. The Impact of Preoperative Angiographic Identification of the Artery of Adamkiewicz on Surgical Decision Making in Patients Undergoing Thoracolumbar Corpectomy. Spine 2015; 40 (15) 1194-1199
- 14 Nijenhuis RJ, Jacobs MJ, Jaspers K. , et al. Comparison of magnetic resonance with computed tomography angiography for preoperative localization of the Adamkiewicz artery in thoracoabdominal aortic aneurysm patients. J Vasc Surg 2007; 45 (04) 677-685
- 15 Awai K, Hatcho A, Nakayama Y. , et al. Simulation of aortic peak enhancement on MDCT using a contrast material flow phantom: feasibility study. AJR Am J Roentgenol 2006; 186 (02) 379-385
- 16 Fleischmann D, Rubin GD, Bankier AA, Hittmair K. Improved uniformity of aortic enhancement with customized contrast medium injection protocols at CT angiography. Radiology 2000; 214 (02) 363-371
- 17 Yoshioka K, Niinuma H, Ehara S, Nakajima T, Nakamura M, Kawazoe K. MR angiography and CT angiography of the artery of Adamkiewicz: state of the art. Radiographics 2006; 26 (Suppl. 01) S63-S73
- 18 Melissano G, Bertoglio L, Civelli V. , et al. Demonstration of the Adamkiewicz artery by multidetector computed tomography angiography analysed with the open-source software OsiriX. Eur J Vasc Endovasc Surg 2009; 37 (04) 395-400
- 19 Utsunomiya D, Yamashita Y, Okumura S, Urata J. Demonstration of the Adamkiewicz artery in patients with descending or thoracoabdominal aortic aneurysm: optimization of contrast-medium application for 64-detector-row CT angiography. Eur Radiol 2008; 18 (11) 2684-2690