MDCT Angiography of the Spinal Vasculature and the Artery of Adamkiewicz

Abstract

Contrast-enhanced 40-MDCT technology, in combination with an adapted brain reconstruction algorithm, can depict the artery of Adamkiewicz and its anatomic variants.

Anatomia da circulação medular

“…Posterior branch of the radicular artery posterior radicular a., 9,10,20 medullary a., 12 posterior medullary a., 18 posterior radiculomedullary aa., 16 a. radicular posterior, 19 posterior segmental medullary a. Anterior spinal artery a. spinalis anterior; 5,6 anterior spinal a., [12][13][14]18 anterior median spinal a., 10 anterior long spinal a. Artéria espinhal anterior (TA)…”

Detection of the Adamkiewiczartery in computed tomography of the thorax and abdomen

“…2 Boll et al reported that using a brain reconstruction system can minimize beam hardening artefacts from high-density osseous structures and obscuration of sharp delineation of vasculature. 10 In contrast, in the present study a standard examination protocol was used without using any additional software. 10 Yoshioka et al used their CTA automatic triggering system for a delayed scan of a 10 mm region of interest (ROI) located in the descending aorta at the level of T7.…”

“…10 In contrast, in the present study a standard examination protocol was used without using any additional software. 10 Yoshioka et al used their CTA automatic triggering system for a delayed scan of a 10 mm region of interest (ROI) located in the descending aorta at the level of T7. In their study, aortic density was measured 3 times per s, and when the value reached a point of 130 HU, a helical CT began automatic scanning.…”

“…11 Boll et al used a similar system called automatic bolus tracking, with the peak of enhancement at 150 HU, after which scanning was automatically initiated. 10 When performing an examination that aims to detect the AKA -a vessel characterized by a variable and wide range of origin -it is very important to set a wide range for the scanned area. Enlargement of the craniocaudal scanning direction takes a few s in CTA, which is superior to magnetic resonance angiography (MRA), in which it takes a few min or longer.…”

“…20 Boll et al reported that using a brain reconstruction system can minimize beam hardening artifacts from high-density osseous structures and obscuration of sharp delineation of vasculature, while in our study standard protocol and reconstructions were used. 10 The tube voltage of the CT scanner is very important, because lower voltages lead to stronger attenuation by intravascular contrast material compared to higher voltages. In the present study the tube voltage was 120 kV and the detection rate was about 22%, while Nijenhuis et al reported a 77% detection rate using 80 kV and only 31% using 120 kV (which is much closer to the results of the present study).…”