The effect of patient positioning on the relative position of the aorta to the thoracic spine

Plataniotis, N.; Evangelopoulos, Dimitrios Stergios; Katzouraki, Galateia; Pneumaticos, Spiros G.

doi:10.1007/s00586-018-5812-9

Cited by 12 publications

(9 citation statements)

References 25 publications

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“…Qian et al studied the supine versus prone position with MRI but did not find any significant changes in a low thoracic-high lumbar region [ 17 ]. Similarly, at higher levels of the thoracic aorta (T4-T12), a significant relationship between patient positioning and the aorta’s relative position was demonstrated between supine and prone positions [ 18 ]. This was also found by Jiang et al, who concluded that the aorta shifts more anteromedially and closer to the spine by ~ 4 mm at T5–T10 levels when patients are changed from the supine to the prone position [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Endograft position and endoleak detection after endovascular abdominal aortic repair with low-field tiltable MRI: a feasibility study

van Zandwijk,

Schuurmann,

Haken

et al. 2023

Eur Radiol Exp

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Background Abdominal aortic endoleaks after endovascular aneurysm repair might be position-dependent, therefore undetectable using supine imaging. We aimed to determine the feasibility and benefit of using a low-field tiltable magnetic resonance imaging (MRI) scanner allowing to study patients who can be imaged in both supine and upright positions of endoleaks. Methods Ten EVAR patients suspected of endoleak based on ultrasound examination were prospectively included. MRI in upright and supine positions was compared with routine supine computed tomography angiography (CTA). Analysis was performed through (1) subjective image quality assessment by three observers, (2) landmark registration between MRI and CTA scans, (3) Euclidean distances between renal and endograft landmarks, and (4) evaluation of endoleak detection on MRI by a consensus panel. Statistical analysis was performed by one-way repeated measures analysis of variance. Results The image quality of upright/supine MRI was inferior compared to CTA. Median differences in both renal and endograft landmarks were approximately 6–7 mm between upright and supine MRI and 5–6 mm between supine MRI and CTA. In the proximal sealing zone of the endograft, no differences were found among all three scan types (p = 0.264). Endoleak detection showed agreement between MRI and CTA in 50% of the cases, with potential added value in only one patient. Conclusions The benefit of low-field upright MRI for endoleak detection was limited. While MRI assessment was non-inferior to standard CTA in detecting endoleaks in selected cases, improved hardware and sequences are needed to explore the potential of upright MRI in patients with endoleaks. Relevance statement Upright low-field MRI has limited clinical value in detecting position-dependent endoleaks; improvements are required to fulfil its potential as a complementary modality in this clinical setting. Key points • Upright MRI shows potential for imaging endoleaks in aortic aneurysm patients in different positions. • The image quality of upright MRI is inferior to current techniques. • Upright MRI complements CTA, but lacks accurate deformation measurements for clinical use. • Advancements in hardware and imaging sequences are needed to fully utilise upright MRI capabilities. Graphical Abstract

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Section: Discussionmentioning

confidence: 99%

Endograft position and endoleak detection after endovascular abdominal aortic repair with low-field tiltable MRI: a feasibility study

van Zandwijk,

Schuurmann,

Haken

et al. 2023

Eur Radiol Exp

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“…Moreover, the CTA scans were obtained with the patients in the supine position, while osteotomy were performed with the patients in the prone position. However, no signi cant change of the relative positions between the aorta and the vertebrae after the patient turned to a prone position in ankylosing spondylitis patients with thoracolumbar kyphosis was reported 19,20 . Further studies of patients with different positions are needed to address this issue.…”

Section: Discussionmentioning

confidence: 99%

Different Angular Kyphosis Locations Have Different Relative Positions of Aorta to Spine in Patients with Pott's Deformity

Jiang

Liao

et al. 2022

Preprint

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Background. The position of the aorta relative to the spine in kyphosis secondary to ankylosing spondylitis is little understood. The purpose of this study was to investigate the anatomic relationship between the aorta and the spine in patients with Pott's deformity and to compare it with the normal people.Methods. Seventy-six patients with Pott's deformity (Group TB) and seventy-two age- and sex-matched patients with a normal spine (group NC) were enrolled in this study. The relative position of aorta to the spine was evaluated from T4 to L4 on the computed tomographic angiography scans for controls and at the apex level for TB patient, and was classified into 4 kinds of degrees. Results. The left pedicle-aorta angle in group TB was significantly larger than that in group NC at the T6-L3 levels. Group TB exhibited significantly smaller left pedicle-aorta distance, pedicular line-aorta distance and vertebra/rib-aorta distance than those in group NC at the T5-T10 levels, but bigger at the L1-3 levels. Patients with grade 3 and 4 aorta had more segments involved compared with those with grade 1 aorta. Patients with grade 2, 3, and 4 aorta showed larger kyphotic angles than those with grade 1.Conclusions. Patients whose morbid segments involved only thoracic vertebrae presented with an “Ω” shaped aorta in sagittal plane, and 4 different kinds of degrees of aorta relative to the vertebra/rib in axial plane. Patients whose morbid segments covered lumbar vertebrae presented with an “M” shaped aorta in sagittal plane, and the aorta shifted further from apex vertebra but was located in close proximity to the vertebral body at levels above and below the osteotomy levels in axial plane.

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“…Surgical reports have described significant aorta shifts between prone and supine positions, with the aorta lying posterolateral to the thoracolumbar spine in the supine position and moving to a more anteromedial position when prone. [5][6][7] Its mobility is more pronounced at mid-thoracic spinal levels, but significant changes in aorto-vertebral angle 5 and distance 6 have been shown up to T12. At L1 and L2, Huitema et al…”

Section: Discussionmentioning

confidence: 99%

Substantial Distortion of the Aorta During Celiac Plexus Stereotactic Body Radiation: A Case Report

Keilty

Winter

Gao

et al. 2022

Advances in Radiation Oncology

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The effect of patient positioning on the relative position of the aorta to the thoracic spine

Cited by 12 publications

References 25 publications

Endograft position and endoleak detection after endovascular abdominal aortic repair with low-field tiltable MRI: a feasibility study

Endograft position and endoleak detection after endovascular abdominal aortic repair with low-field tiltable MRI: a feasibility study

Different Angular Kyphosis Locations Have Different Relative Positions of Aorta to Spine in Patients with Pott's Deformity

Substantial Distortion of the Aorta During Celiac Plexus Stereotactic Body Radiation: A Case Report

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