Department of Radiology, Sapporo Medical University, Sapporo, Japan.
Magn Reson Med Sci. 2009;8(4):159-64. doi: 10.2463/mrms.8.159.
We evaluated the efficacy of magnetic resonance angiography (MRA) for detecting the artery of Adamkiewicz (AKA) and the vertebral level of its feeding arteries branching from the aorta.
Eighty-two patients (67 men, 15 women; aged 34 to 86 years, mean age 68.6 years) with thoracic descending and thoracoabdominal aortic lesions (aneurysm in 55, dissection in 25, coarctation in 2) underwent MRA to detect AKA. MRA was performed using 6-phase, dynamic-enhanced, 3-dimensional, fast spoiled gradient recalled acquisition in steady state (GRASS) on a 1.5-tesla (T) system, with double-dose bolus contrast injection. The vertebral levels of AKA branching and the AKA feeder artery branching from the aorta were determined.
The AKA was detected in 67 patients (81.7%). Branching of AKA occurred at levels T7 to T12 on the left side (n=52) and on the right (n=15). Vascular continuity from the aorta to the anterior spinal artery was demonstrated in 55 patients (67.1%). Comparing the vertebral level of arterial branching from the aorta to that of the AKA at the intervertebral foramen, the AKA branched at the same vertebral level in 44 patients (80.0%), one vertebral level above/below in 10 (18.2%), and 2 vertebral levels above in one (1.8%).
MRA can be useful in the preoperative work-up of patients with thoracoabdominal aortic lesions to localize AKA and the segmental trajectories of vessels supplying blood to the AKA.
我们评估磁共振血管造影（MRA）检测 Adamkiewicz 动脉（AKA）及其从主动脉分支的供养动脉在椎体水平的效能。
82 例（男 67 例，女 15 例；年龄 34-86 岁，平均 68.6 岁）胸降主动脉和胸腹主动脉病变患者（动脉瘤 55 例，夹层 25 例，缩窄 2 例）接受 MRA 以检测 AKA。MRA 使用 1.5T 系统的 6 期动态增强三维快速扰相梯度回波稳态（GRASS）进行，双剂量团注造影剂。确定 AKA 分支和从主动脉分支的 AKA 供养动脉的椎体水平。
67 例（81.7%）患者检测到 AKA。左侧（n=52）和右侧（n=15）的 T7-T12 椎体水平出现 AKA 分支。55 例（67.1%）患者显示从主动脉到脊髓前动脉的血管连续性。比较从主动脉到椎间孔 AKA 供养动脉分支的椎体水平，44 例（80.0%）患者的 AKA 在同一椎体水平分支，10 例（18.2%）在同一椎体水平以上/以下分支，1 例（1.8%）在两个椎体水平以上分支。
MRA 可用于胸主动脉病变患者的术前评估，以定位 AKA 和供应 AKA 的血管节段性轨迹。
