Display of Adamkiewicz artery with MSCT angiography

Objective: To display and evaluate Adamkiewicz artery (AKA) with 320-slice CTA, and to discuss the appropriate scan protocol of AKA. Methods: A total of 120 patients with suspected aortic diseases were randomly divided into four groups (group A1, A2, B1, B2) with different scan protocols. Group A1 and A2 were injected by iodine contrast medium of 350 mgI/ml, and group B1 and B2 were injected by iodine contrast medium of 370 mgI/ml. Acquisition time of group A1 and B1 were delayed 15 s, group A2 and B2 were delayed 18 s. The imagings of AKA were evaluated by two radiologists. Display rates of AKA were compared among the groups. The agreement between the two doctors was tested with Cohen test. Results: All 120 patients underwent the examination successfully. AKA could be identified in 85 of 120 patients, 98 branches could be depicted and located from T7 to L1. Eighty-one branches (82.65%, 81/98) located from T9 to L1, and 75 branches (75/98, 76.53%) originated from the left intercostal or lumbar arteries. The display rate of AKA was 63.33% (19/30) in group A1, 66.67% (20/30) in group A2, 70.00%(21/30) in group B1, 83.33%(25/30) in group B2, respectively. Though delay time and concentration of contrast medium had not significant impact on determination the display rate of AKA (all P>0.05), the display rate of AKA in group B2 was higher than that of the other groups. The correlation between two doctors was excellent (Kappa value=0.94). Conclusion: Using appropriate scan protocol, 320-slice CTA can simultaneously show aortic diseases and depict AKA.