Kawaharada Nobuyoshi, Morishita Kiyofumi, Hyodoh Hideki, Fujisawa Yasuaki, Fukada Johji, Hachiro Yoshikazu, Kurimoto Yoshihiko, Abe Tomio
Department of Thoracic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
Ann Thorac Surg. 2004 Sep;78(3):846-51; discussion 851-2. doi: 10.1016/j.athoracsur.2004.02.085.
The purpose of this study was to determine whether the artery of Adamkiewicz (ARM) can be detected by magnetic resonance angiography and to determine the usefulness of preoperative magnetic resonance angiography evaluation of the ARM.
Between April 2000 and December 2003, 120 patients underwent magnetic resonance angiography for detection of the ARM. The morphology of the anterior spinal artery at the ARM junction, as revealed by magnetic resonance angiography, in 99 patients in whom ARM was preoperatively detected was classified into the following three types: noncontinuation of the anterior spinal artery above the ARM junction (type A), continuation of the anterior spinal artery above and below the ARM junction (type B), and noncontinuation of the anterior spinal artery below the ARM junction (type C).
The ARMs were detected in 99 (83%) of 120 patients, and from a total of 110 ARMs 105 (95%) originated from intercostal arteries branching from the left side and 94 (86%) originated between Th9 and Th11. Two ARMs were found in 11 (11%) of 99 patients in whom ARMs were detected. In 107 patients, who underwent magnetic resonance angiography to reveal the morphology of the anterior spinal artery at the ARM junction, the patterns of the anterior spinal artery were type A in 59 patients (55%), type B in 21 patients (20%), type C in 3 patients (3%) and not classified in 24 patients (22%). No spinal cord injury occurred in patients in whom the ARM had been preoperatively detected.
Preoperative detection of the ARM is possible by magnetic resonance angiography and is very useful for reducing the incidence of ischemic injury of the spinal cord.
本研究的目的是确定能否通过磁共振血管造影检测到Adamkiewicz动脉（ARM），并确定术前磁共振血管造影对ARM评估的有用性。
2000年4月至2003年12月期间，120例患者接受了磁共振血管造影以检测ARM。在术前检测到ARM的99例患者中，根据磁共振血管造影显示的ARM连接处脊髓前动脉的形态，分为以下三种类型：ARM连接处上方脊髓前动脉不连续（A型）、ARM连接处上方和下方脊髓前动脉连续（B型）、ARM连接处下方脊髓前动脉不连续（C型）。
120例患者中有99例（83%）检测到ARM，在总共110条ARM中，105条（95%）起源于左侧肋间动脉分支，94条（86%）起源于胸9和胸11之间。在检测到ARM的99例患者中，11例（11%）发现有两条ARM。在107例接受磁共振血管造影以显示ARM连接处脊髓前动脉形态的患者中，脊髓前动脉的模式为：59例（55%）为A型，21例（20%）为B型，3例（3%）为C型，24例（22%）未分类。术前检测到ARM的患者未发生脊髓损伤。
通过磁共振血管造影术前检测ARM是可行的，对降低脊髓缺血性损伤的发生率非常有用。
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