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Ultra-high-resolution CT angiography of the artery of Adamkiewicz: a feasibility study

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Abstract

Purpose

Preoperative identification of the artery of Adamkiewicz can help prevent postoperative spinal cord injury following thoracic and thoracoabdominal aortic repair. Several studies have demonstrated the feasibility of evaluating the artery of Adamkiewicz using multi-detector row computed tomography (CT), but precise visualization remains a challenge. The present study was conducted to evaluate the usefulness of ultra-high-resolution CT for visualizing the artery of Adamkiewicz with a slice thickness of 0.25 versus 0.5 mm in patients with aortic aneurysms.

Methods

Our institutional review board approved this study. Twenty-four patients with thoracic and thoracoabdominal aneurysms were scanned with beam collimation of 0.25 mm × 128. Images were reconstructed with slice thicknesses of 0.25 and 0.5 mm. The signal-to-noise ratio (SNR) of the aorta and contrast-to-noise ratio (CNR) between the anterior spinal artery and spinal cord were measured. Two independent observers evaluated visualization of the artery of Adamkiewicz and its continuity between the anterior spinal artery and the aorta using a four-point scale.

Results

No significant differences in the SNR of the aorta or CNR of the anterior spinal artery were observed between 0.25- and 0.5-mm slices. The average visualization score was significantly higher for 0.25-mm slices (3.58 ± 0.78) than for 0.5-mm slices (3.13 ± 0.99) (p = 0.01). The percentage of patients with nondiagnostic image quality was significantly lower for 0.25-mm slices (8.3%) than for 0.5-mm slices (33.3%) (p = 0.03).

Conclusion

In patients with aortic aneurysms, ultra-high-resolution CT with 0.25-mm slices significantly improves visualization of the artery of Adamkiewicz compared to 0.5-mm slices.

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Authors and Affiliations

  1. Division of Cardiovascular Radiology, Department of Radiology, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan

    Kunihiro Yoshioka, Ryoichi Tanaka & Hidenobu Takagi

  2. Center for Radiological Science, Iwate Medical University Hospital, 19-1 Uchimaru, Morioka, 020-8505, Japan

    Yuta Ueyama, Kei Kikuchi & Takuya Chiba

  3. Center for Medical Research and Development, Toshiba Medical Systems Corporation, 1385 Shimoishigami, Otawara, 323-0036, Japan

    Kazumasa Arakita

  4. Center for Medical Research and Development Europe, Toshiba Medical Systems Europe, Zoetermeer, The Netherlands

    Joanne D. Schuijf

  5. CT Systems Development Department, Toshiba Medical Systems Corporation, 1385 Shimoishigami, Otawara, 323-0036, Japan

    Yasuo Saito

Authors
  1. Kunihiro Yoshioka
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  2. Ryoichi Tanaka
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  3. Hidenobu Takagi
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  4. Yuta Ueyama
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  5. Kei Kikuchi
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  6. Takuya Chiba
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  7. Kazumasa Arakita
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  8. Joanne D. Schuijf
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  9. Yasuo Saito
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Corresponding author

Correspondence to Kunihiro Yoshioka.

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Funding

No funding was received for this study.

Conflict of interest

KA, SJ and YS are employees of Toshiba Medical Systems Corporation. KY and RT have a contract to conduct academic research in cooperation with Toshiba Medical Systems Corporation.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Yoshioka, K., Tanaka, R., Takagi, H. et al. Ultra-high-resolution CT angiography of the artery of Adamkiewicz: a feasibility study. Neuroradiology 60, 109–115 (2018). https://doi.org/10.1007/s00234-017-1927-7

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  • DOI: https://doi.org/10.1007/s00234-017-1927-7

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