Detection of the Adamkiewicz artery in computed tomography of the thorax and abdomen.
BACKGROUND
The great anterior radiculomedullary artery, also known as the artery of Adamkiewicz (AKA), is a small-caliber vessel which arises from the intercostal or lumbar arteries branching out from the aorta.


OBJECTIVES
The aim of this study was to evaluate detection of the AKA, as well as its level and side of origin, with multi-slice contrast enhanced computed tomography (MSCT) of the abdomen and thorax performed during everyday clinical practice, and to compare the results with the literature.


MATERIAL AND METHODS
The study retrospectively evaluated 200 consecutive MSCT images of the thoracic and thoracoabdominal aorta performed at Wroclaw Medical University's Department of General and Interventional Radiology and Neuroradiology as part of normal clinical work-ups. The CT examinations were performed with a 64-slice CT scanner. Arterial-phase images were analyzed for detection of the AKA and for anatomical variants of the AKA.


RESULTS
Recognition of the AKA was achieved in 43 of 200 patients (21.5%). Out of these 43 cases, the AKA originated on the left side in 36 instances (83.7%) - a significantly higher number than on the right side (only in 6 cases, 14%); in one case (2.3%) it arose from both sides (p < 0.05, T-test). Most of the AKAs (24 cases, 55.8%) originated on the left side at level T11 or T12. In 13 patients (30.2%) the AKA arose from T11 or from T12 intercostal arteries. The origin of the AKA varied greatly and ranged from T5 (2.3%) to L2 (2.3%).


CONCLUSIONS
The AKA is characterized by left-side lateralization and is associated with a wide range of origin, from T5 to L2. Detection of the AKA is, relatively speaking, rarely possible in routine clinical CT in the arterial phase - only in 1/5 of the patients. Therefore it is necessary to perform dedicated, individual arterial phase bolus tracking enhancement CT scans from the T5 to L3 level.
['Guziński|Maciej|M|', 'Bryl|Maciej|M|', 'Ziemińska|Katarzyna|K|', 'Wolny|Kamila|K|', 'Sąsiadek|Marek|M|', 'Garcarek|Jerzy S|JS|']
D000005:Abdomen D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D001158:Arteries D002648:Child D005260:Female D006801:Humans D007091:Image Processing, Computer-Assisted D008297:Male D008875:Middle Aged D012189:Retrospective Studies D013116:Spinal Cord D013909:Thorax D014057:Tomography, X-Ray Computed D055815:Young Adult
great anterior radiculomedullary artery Adamkiewicz artery (AKA) computed tomograpy (CT)