Melissano G, Bertoglio L, Civelli V, Amato A C Moraes, Coppi G, Civilini E, Calori G, De Cobelli F, Del Maschio A, Chiesa R
Scientific Institute H. San Raffaele, Chair of Vascular Surgery, Vita Salute San Raffaele University, Milan, Italy.
Eur J Vasc Endovasc Surg. 2009 Apr;37(4):395-400. doi: 10.1016/j.ejvs.2008.12.022. Epub 2009 Feb 20.
To evaluate the feasibility of the Adamkiewicz artery (AKA) detection by multidetector computed tomography (CT) data analysis without the need of a dedicated workstation, using low-cost hardware and the freeware OsiriX.
CT scans of 67 patients undergoing a thoracic or thoraco-abdominal aortic procedure between April 2006 and August 2008 were evaluated with respect to detection rate and AKA level and side using the OsiriX software version 3.2 on Mac OS X computer and compared to results obtained by standard workstation analysis, in a fully blinded analysis. The results were also compared with data compiled from a review of the English-language literature on this topic.
(1) AKA identification showed a substantial agreement of 85.07% between the methods (k=0.636). (2) The comparison of AKA level showed a substantial agreement (weighted k=0.661), with consensus in 70.14%. (3) From the literature review, we found that recognition of the AKA was achieved in 466 of 555 cases (83.96%). (4) In 384 (83.3%) cases the AKA originated from a left intercostal artery. (5) The proposed method and literature-compiled data showed a similar AKA level distribution.
Noninvasive AKA location with open-source software and low-cost hardware is feasible. The OsiriX software allows to effectively navigate through CT data not only to study the aorta, but also to detect the AKA, as in the case of the standard method and the literature data. Its availability and ease of use may contribute to make identification of the AKA part of the routine evaluation of CT scans in patients with aortic disease, even where dedicated workstations are not available, with potential benefits for planning therapeutic procedures.
通过多探测器计算机断层扫描（CT）数据分析，在无需专用工作站的情况下，使用低成本硬件和免费软件OsiriX评估Adamkiewicz动脉（AKA）检测的可行性。
对2006年4月至2008年8月期间接受胸主动脉或胸腹主动脉手术的67例患者的CT扫描进行评估，使用Mac OS X计算机上的OsiriX软件版本3.2，就检测率、AKA水平和侧别进行评估，并与标准工作站分析获得的结果进行完全盲法分析比较。结果还与从关于该主题的英文文献综述中汇编的数据进行了比较。
（1）AKA识别在两种方法之间显示出85.07%的高度一致性（k = 0.636）。（2）AKA水平比较显示出高度一致性（加权k = 0.661），一致性为70.14%。（3）从文献综述中，我们发现555例中有466例（83.96%）识别出了AKA。（4）在384例（83.3%）病例中，AKA起源于左肋间动脉。（5）所提出的方法和文献汇编数据显示出相似的AKA水平分布。
使用开源软件和低成本硬件进行无创性AKA定位是可行的。OsiriX软件不仅能够有效地浏览CT数据以研究主动脉，还能像标准方法和文献数据那样检测AKA。其可用性和易用性可能有助于使AKA识别成为主动脉疾病患者CT扫描常规评估的一部分，即使在没有专用工作站的情况下，这对治疗方案的规划可能具有潜在益处。
