J Korean Radiol Soc.  2007 Jan;56(1):63-68.

Usefulness of Spinal MR Angiography for Detecting Adamkiewicz Artery

• Yun BL
• Lee JW
• Jun WS
• Kwack KS
• Lee JS
• Kim SH
• Myung JS
• Jeong HS
• Kim JH
• Kim JH
• Kang HS

Abstract

PURPOSE
We wanted to evaluate the detection rate of the artery of Adamkiewicz (AKA) by contrast-enhanced MR angiography (CE-MRA) and to compare the detection rate of AKA between the coronal source image plane and the sagittal source image plane.
MATERIALS AND METHODS
Between December 2004 and May 2005, 23 patients (9 men and 14 women. age range: 11-86 years, mean age: 43 years) who were examined by contrast-enhanced MRI for the purpose of evaluating spondylopathy were also studied by performing spinal CE-MRA. Spinal CE-MRA was performed with a 1.5-T system and with using 3D Fast field echo with a double dose (0.2 mmol/kg) of Gadolinium. Source images were obtained in either the sagittal plane (n = 11) or the coronal plane (n = 12) at random. The source images were reconstructed with multiplanar reconstruction and maximum intensity projection. Two radiologists, who were kept unaware of the source image plane, independently evaluated the CE-MRA with focusing on the AKA. The detection rate was evaluated and the difference of detection rates according to the source image plane was compared and analyzed.
RESULTS
CE-MRA could demonstrate the AKA in 11 (47%) of the 23 patients. The interobserver agreement for detection was fair (κ=0.283). Among the 11 patients in whom the MRA was obtained with using the coronal plane source image, CE-MRA detected the AKA in three of them (27%); among the 12 patients in whom the CE-MRA was obtained with using the sagittal plane source image, CE-MRA detected the AKA in 8 of them (67%, p = 0.059). The AKA in 7 cases (63%) originated from the intercostal or lumbar arteries on the left side at L2 (n = 3), L1 (n = 2), T12 (n = 1) or T9 (n = 1), and on the right side at L1 (n = 1) or T12 (n = 3). CE-MRA with coronal slice orientation visualized the AKA in 8 (67%) of the 11 patients (p = 0.059).
CONCLUSION
The detection rate of AKA by CE-MRA was 47%. By obtaining the source image in the coronal plane, the detection rate of AKA was 67%.

Keyword

Magnetic resonance (MR); Angiography; Spinal cord; Arteries

MeSH Terms

Angiography*
Arteries*
Female
Gadolinium
Humans
Magnetic Resonance Imaging
Male
Spinal Cord
Gadolinium