Systematic evaluation of collateral pathways to the artery of Adamkiewicz using computed tomography
Systematic evaluation of collateral pathways to the artery of Adamkiewicz using computed tomography
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DOI：
10.1093/ejcts/ezx509
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发表时间：
2018-07-01
影响因子：
3.4
通讯作者：
Schuijf, Joanne D.
中科院分区：
文献类型：
--
作者：
Yoshioka, Kunihiro;Tanaka, Ryoichi;Schuijf, Joanne D.
目的：术前识别Adamkiewicz动脉有助于预防胸主动脉瘤和胸腹主动脉瘤修复术患者术后脊髓损伤。虽然几项研究表明，使用多排计算机断层扫描（MDCT）评估Adamkiewicz动脉的可行性，但尚未进行有关Adamkiewicz动脉侧支循环的详细调查。本研究的目的是探讨侧支循环的Adamkiewicz动脉使用MDCT患者胸和胸腹主动脉瘤。方法：我们的机构审查委员会批准了这项研究。使用64或320探测器行计算机断层扫描与段动脉闭塞相关的胸降主动脉瘤和胸腹主动脉瘤患者，段动脉起源于Adamkiewicz动脉。两个独立的观察员评估的MDCT图像的基础上的Adamkiewicz动脉及其侧支循环的可视化程度，使用4-pointscale.RESULTS：平均可视化评分为2.8 +/- 0.6。64例患者中有53例（83%）的图像质量被判定为诊断性。在这53例患者中，MDCT显示了75条至Adamkiewicz动脉的侧支循环。六十四的75（85%）的途径是侧支周围的脊柱，和其余的11（15%）的途径是侧支动脉在thoracic wall.CONCLUSIONS：MDCT显示的侧支通路的动脉Adamkiewicz周围的脊柱和在我们的患者的胸和胸腹主动脉瘤的83%的胸壁。
OBJECTIVES: Preoperative identification of the artery of Adamkiewicz can help prevent postoperative spinal cord injury in patients undergoing thoracic and thoraco-abdominal aortic aneurysm repair. Although several studies have shown the feasibility of evaluating the artery of Adamkiewicz using multidetector row computed tomography (MDCT), no detailed investigations regarding the collateral circulation to the artery of Adamkiewicz have been performed. The purpose of this study was to investigate the collateral circulation to the artery of Adamkiewicz using MDCT in patients with thoracic and thoraco-abdominal aortic aneurysms.METHODS: Our institutional review board approved this study. Sixty-four patients with descending thoracic and thoraco-abdominal aortic aneurysms associated with the occlusion of the segmental artery from which the artery of Adamkiewicz originated were scanned using 64- or 320-detector row computed tomography. Two independent observers evaluated the MDCT images based on the degree of visualization of the artery of Adamkiewicz and its collateral circulation using a 4-point scale.RESULTS: The average visualization score was 2.8 +/- 0.6. In 53 of the 64 (83%) patients, image quality was judged to be diagnostic. MDCT demonstrated 75 collateral pathways to the artery of Adamkiewicz in these 53 patients. Sixty-four of the 75 (85%) pathways were collaterals around the spinal column, and the remaining 11 (15%) pathways were collateral arteries in the thoracic wall.CONCLUSIONS: MDCT revealed the collateral pathways to the artery of Adamkiewicz around the spinal column and in the thoracic wall in 83% of our patients with thoracic and thoraco-abdominal aortic aneurysms.