Yoshioka Kunihiro, Tanaka Ryoichi, Takagi Hidenobu, Ueyama Yuta, Kikuchi Kei, Chiba Takuya, Arakita Kazumasa, Schuijf Joanne D, Saito Yasuo
Division of Cardiovascular Radiology, Department of Radiology, Iwate Medical University, 19-1 Uchimaru, Morioka, 020-8505, Japan.
Center for Radiological Science, Iwate Medical University Hospital, 19-1 Uchimaru, Morioka, 020-8505, Japan.
Neuroradiology. 2018 Jan;60(1):109-115. doi: 10.1007/s00234-017-1927-7. Epub 2017 Oct 28.
Preoperative identification of the artery of Adamkiewicz can help prevent postoperative spinal cord injury following thoracic and thoracoabdominal aortic repair. Several studies have demonstrated the feasibility of evaluating the artery of Adamkiewicz using multi-detector row computed tomography (CT), but precise visualization remains a challenge. The present study was conducted to evaluate the usefulness of ultra-high-resolution CT for visualizing the artery of Adamkiewicz with a slice thickness of 0.25 versus 0.5 mm in patients with aortic aneurysms.
Our institutional review board approved this study. Twenty-four patients with thoracic and thoracoabdominal aneurysms were scanned with beam collimation of 0.25 mm × 128. Images were reconstructed with slice thicknesses of 0.25 and 0.5 mm. The signal-to-noise ratio (SNR) of the aorta and contrast-to-noise ratio (CNR) between the anterior spinal artery and spinal cord were measured. Two independent observers evaluated visualization of the artery of Adamkiewicz and its continuity between the anterior spinal artery and the aorta using a four-point scale.
No significant differences in the SNR of the aorta or CNR of the anterior spinal artery were observed between 0.25- and 0.5-mm slices. The average visualization score was significantly higher for 0.25-mm slices (3.58 ± 0.78) than for 0.5-mm slices (3.13 ± 0.99) (p = 0.01). The percentage of patients with nondiagnostic image quality was significantly lower for 0.25-mm slices (8.3%) than for 0.5-mm slices (33.3%) (p = 0.03).
In patients with aortic aneurysms, ultra-high-resolution CT with 0.25-mm slices significantly improves visualization of the artery of Adamkiewicz compared to 0.5-mm slices.
术前识别Adamkiewicz动脉有助于预防胸主动脉和胸腹主动脉修复术后的脊髓损伤。多项研究已证明使用多排螺旋计算机断层扫描（CT）评估Adamkiewicz动脉的可行性，但精确显影仍是一项挑战。本研究旨在评估超高分辨率CT对主动脉瘤患者Adamkiewicz动脉的显影效果，比较层厚0.25 mm与0.5 mm的差异。
本研究经机构审查委员会批准。对24例胸主动脉和胸腹主动脉瘤患者进行了层厚0.25 mm×128的扫描。图像重建层厚为0.25 mm和0.5 mm。测量主动脉的信噪比（SNR）以及脊髓前动脉与脊髓之间的对比噪声比（CNR）。两名独立观察者使用四点量表评估Adamkiewicz动脉的显影情况及其与脊髓前动脉和主动脉之间的连续性。
0.25 mm和0.5 mm层厚的主动脉SNR或脊髓前动脉的CNR无显著差异。0.25 mm层厚的平均显影评分（3.58±0.78）显著高于0.5 mm层厚（3.13±0.99）（p = 0.01）。图像质量无法诊断的患者百分比，0.25 mm层厚（8.3%）显著低于0.5 mm层厚（33.3%）（p = 0.03）。
对于主动脉瘤患者，与0.5 mm层厚相比，0.25 mm层厚的超高分辨率CT显著改善了Adamkiewicz动脉的显影效果。
