Boll Daniel T, Bulow Hubertus, Blackham Kristine A, Aschoff Andrik J, Schmitz Bernd L
Department of Radiology, University Hospitals of Cleveland, 11100 Euclid Ave., Cleveland, OH 44106, USA.
AJR Am J Roentgenol. 2006 Oct;187(4):1054-60. doi: 10.2214/AJR.05.0562.
The purpose of our study was to prospectively assess 40-MDCT technology in combination with adapted brain reconstruction algorithms to visualize the spinal vasculature, in particular the artery of Adamkiewicz and its anatomic variants.
One hundred patients underwent contrast-enhanced MDCT of the thoracolumbar junction with collimation of 40 x 0.625 mm. The adapted brain algorithm reconstructed the spinal canal with a field of view of 90 mm at 0.6-mm slice thickness. Curved multiplanar reformations identified the artery of Adamkiewicz as a continuous vascular tract extending from the aortic orifices of the intercostal or lumbar arteries via the anterior radiculomedullary artery to the anterior spinal artery. Segment of origin and length were noted. Diameter and contrast-to-noise ratio (CNR) were evaluated along the posterior branch, the radiculomedullary artery, the artery of Adamkiewicz, and the anterior spinal artery. Univariate general linear model analysis with Bonferroni post hoc corrections evaluated whether laterality, segment of origin, and length of the artery of Adamkiewicz showed a sex-specific propensity. Multivariate general linear model analysis assessed whether spinal vascular diameters and intraluminal CNR showed correlations with sex, laterality, and segment of origin. Finally, the luminal diameters of the feeding posterior branches were statistically compared with those of the ipsilateral and contralateral adjacent posterior branches.
Successful depiction of the artery of Adamkiewicz was achieved in all patients; longitudinally the artery measured 40.1 +/- 13.51 mm. In 63% of patients it originated from the left side of the body, and in 74% it originated from the level of the 10th-12th thoracic vertebrae. Duplications were found in 5% of patients. Segmental distribution, laterality, and length did not show significant sex-specific differences (p > 0.05). The vascular diameter and luminal contrast did not show significant differences caused by sex, laterality, or segment of origin (p > 0.05). The diameter of the posterior branches (2.8 +/- 0.71 mm) arising in the segments of origin showed a significantly wider lumen than any of the other posterior branches (contralateral, 1.9 +/- 0.32 mm; upper ipsilateral, 2.0 +/- 0.47 mm; lower ipsilateral, 1.9 +/- 0.39 mm) (p < 0.0001).
Contrast-enhanced 40-MDCT technology, in combination with an adapted brain reconstruction algorithm, can depict the artery of Adamkiewicz and its anatomic variants.
我们研究的目的是前瞻性评估40层多层螺旋CT（MDCT）技术结合适应性脑重建算法来可视化脊髓血管，特别是Adamkiewicz动脉及其解剖变异。
100例患者接受了胸腰段的对比增强MDCT检查，准直为40×0.625mm。适应性脑算法以0.6mm层厚、90mm视野重建椎管。曲面多平面重组将Adamkiewicz动脉识别为一条连续的血管束，从肋间或腰动脉的主动脉口经前根髓动脉延伸至脊髓前动脉。记录其起源节段和长度。沿后支、根髓动脉、Adamkiewicz动脉和脊髓前动脉评估直径和对比噪声比（CNR）。采用Bonferroni事后校正的单因素一般线性模型分析评估Adamkiewicz动脉的侧别、起源节段和长度是否存在性别特异性倾向。多因素一般线性模型分析评估脊髓血管直径和管腔内CNR是否与性别、侧别和起源节段相关。最后，对供血后支的管腔直径与同侧和对侧相邻后支的管腔直径进行统计学比较。
所有患者均成功显示了Adamkiewicz动脉；其纵向长度为40.1±13.51mm。63%的患者其起源于身体左侧，74%起源于第10至12胸椎水平。5%的患者发现有重复。节段分布、侧别和长度未显示出明显的性别特异性差异（p>0.05）。血管直径和管腔对比度未显示出由性别、侧别或起源节段引起的显著差异（p>0.05）。起源节段发出的后支直径（2.8±0.71mm）显示管腔明显宽于其他任何后支（对侧，1.9±0.32mm；同侧上方，2.0±0.47mm；同侧下方，1.9±0.39mm）（p<0.0001）。
对比增强40层MDCT技术结合适应性脑重建算法能够显示Adamkiewicz动脉及其解剖变异。
