Identifying the Adamkiewicz artery using 3-T time-resolved magnetic resonance angiography: its role in addition to multidetector computed tomography angiography.

Abstract

This study assessed Adamkiewicz artery (AKA) detectability using multidetector computed tomography angiography (MDCTA) and time-resolved magnetic resonance angiography (MRA) at 3 T. This Institutional Review Board-approved retrospective study included 117 patients with thoracoabdominal aortic disease scheduled for aortic repair. A total of 111 patients underwent MDCTA for AKA identification; 43 patients whose AKA identification was not definitive on MDCTA underwent additional MRA. The remaining six patients, who were not indicated for iodine-contrast MDCTA, underwent only MRA. Two reviewers independently evaluated both MDCTA and MRA data. The 4-point confidence index was used. Grades 3-4 were considered sufficient for AKA diagnosis. AKA detectability was at 80.2% (89/111) using MDCTA and 89.8% (44/49) with MRA. In the 43 patients who underwent both MDTCA and MRA, the AKA detectability and consensus grades were significantly elevated using MRA vs. MDCTA (detectability: 88.4 vs. 69.8%, respectively, p = 0.043). AKA detectability was also higher in aortic aneurysm than aortic dissection patients on MDCTA (90.9 vs. 69.6%, respectively, p < 0.01), but not on MRA (92.9 vs. 88.6%, respectively, p = 0.99). Time-resolved MRA at 3 T increases AKA detectability and is recommended for patients without definitive AKA identification on MDCTA.