Abstract
Objective
Radiographic detection of the Adamkiewicz artery (AKA) before aortic surgery helps
to avoid spinal cord ischemia (SCI). We applied magnetic resonance angiography (MRA)
using gadolinium enhancement (Gd-MRA) by means of the slow-infusion method with sequential
k-space filling and compared AKA detectability with that of computed tomography angiography
(CTA).
Methods
A total of 63 patients with thoracic or thoracoabdominal aortic disease (30 with aortic
dissection [AD] and 33 with aortic aneurysm) who underwent both CTA and Gd-MRA to
detect AKA were evaluated. The detectability of the AKA using Gd-MRA and CTA were
compared among all patients and subgroups based on anatomical features.
Results
The detection rates of the AKAs using Gd-MRA and CTA were higher in all 63 patients
(92.1% vs. 71.4%, p = 0.003). In AD cases, the detection rates using Gd-MRA and CTA
were higher in all 30 patients (93.3% vs. 66.7%, p = 0.01) as well as in seven patients
whose AKA originated from false lumens (100% vs. 0%). In aneurysm cases, the detection
rates using Gd-MRA and CTA were higher in 22 patients whose AKA originated from the
non-aneurysmal parts (100% vs. 81.8%, p = 0.03). In clinical, SCI was observed in
1.8% of cases after open or endovascular repair.
Conclusion
Despite the longer examination time and more complicated imaging techniques compared
to those of CTA, the high spatial resolution of slow-infusion MRA may be preferable
for detecting AKA before performing various thoracic and thoracoabdominal aortic surgeries.
Keywords
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Article info
Publication history
Accepted:
February 22,
2023
Received in revised form:
January 31,
2023
Received:
November 11,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
