Purpose: Identification of the Adamkiewicz artery before aortic surgery is important for preventing postoperative complications due to spinal cord ischemia. The Adamkiewicz artery is difficult to identify due to its small diameter. Nitroglycerin has a vasodilatory effect and is used clinically to improve visualization of blood vessels on coronary computed tomography (CT) angiography. We investigated whether the vasodilatory effect of nitroglycerin could improve the ability to visualize the Adamkiewicz artery.
Methods: We extracted 33 cases wherein contrast-enhanced CT images were taken before and after aortic aneurysm surgery. Nitroglycerin was administered for coronary artery evaluation on the preoperative CT. However, no nitroglycerin was administered before the postoperative CT. Aortic contrast-to-noise ratio, CT value, image noise, and diameter of the Adamkiewicz artery and anterior spinal artery were measured. The depiction of the Adamkiewicz artery was graded into four grades and evaluated. These measurements were performed by two independent reviewers.
Results: In nitroglycerin-administered cases, the contrast-to-noise ratio and CT values were significantly higher (P < 0.001, P < 0.001, respectively); the Adamkiewicz artery and anterior spinal artery diameters were dilated (P = 0.005, P = 0.001, respectively). The Adamkiewicz artery score also improved significantly (P < 0.001). No significant difference was found in image noise.
Conclusion: Nitroglycerin contributed to improving the Adamkiewicz artery's visualization.
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http://dx.doi.org/10.1007/s00234-024-03433-9 | DOI Listing |
Pediatr Int
January 2024
Department of Radiology, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan.
Oper Neurosurg (Hagerstown)
November 2024
Cooper Medical School of Rowan University, Camden, New Jersey, USA.
Acta Radiol
December 2024
Department of Diagnostic Radiology, Hiroshima University, Hiroshima, Japan.
Background: Low-keV virtual monoenergetic images (VMIs) of dual-energy computed tomography (CT) enhances iodine contrast for detecting small arteries like the Adamkiewicz artery (AKA), but image noise can be problematic. Deep-learning image reconstruction (DLIR) effectively reduces noise without sacrificing image quality.
Purpose: To evaluate whether DLIR on low-keV VMIs of dual-energy CT scans improves the visualization of the AKA.
J Pediatr Surg
December 2024
Department of Pediatric Surgery, Bicêtre Hospital, Assistance Publique - Hôpitaux de Paris (APHP), France; Université Paris Saclay, France. Electronic address:
Background And Aims: We aimed to review current literature on the impact of Preoperative Identification (POI) of the Adamkiewicz Artery (AKA) in solid pediatric Posterior Thoracic Tumors (PTT), comprising a spectrum of neuroblastic tumors and neuroblastoma, with particular focus on Complete Macroscopic Excision (CME) and Neurologic Complications/Sequelae (NCS).
Methods: A systematic review in accordance with PRISMA guidelines was undertaken. The study included reports on pediatric patients providing available data on POI of the AKA in PTT.
Cureus
September 2024
Department of Surgery, Division of Cardiovascular Surgery, Shinshu University Hospital, Matsumoto, JPN.
A 53-year-old woman was diagnosed with a Crawford II thoracoabdominal aortic aneurysm involving the right-sided descending aorta. The patient underwent aortic replacement via a thoracoabdominal approach. The right-sided descending thoracic aortic aneurysm was excluded.
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