Identification of Adamkiewicz artery by 4D flow MRI and intra-arterial ultra-high-resolution CT angiography in preoperative assessment of patients with chronic aortic dissection: A case report
Preoperative identification of the Adamkiewicz artery (AKA) with adequate reconstruction or preservation during surgery is useful for protecting the spinal cord from ischemia during thoracoabdominal aortic repair. However, the identification of the AKA remains challenging in some cases, especially w...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-03-01
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| Series: | Radiology Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1930043324013694 |
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| author | Satoshi Higuchi, MD, PhD Yuta Sato, MD Hideki Ota, MD, PhD Ryuichi Mori, RT Yuki Ichinoseki, RT Hitoshi Nemoto, RT Shingo Kayano, RT Kiichiro Kumagai, MD, PhD Yoshikatsu Saiki, MD, PhD Kei Takase, MD, PhD |
| author_facet | Satoshi Higuchi, MD, PhD Yuta Sato, MD Hideki Ota, MD, PhD Ryuichi Mori, RT Yuki Ichinoseki, RT Hitoshi Nemoto, RT Shingo Kayano, RT Kiichiro Kumagai, MD, PhD Yoshikatsu Saiki, MD, PhD Kei Takase, MD, PhD |
| author_sort | Satoshi Higuchi, MD, PhD |
| collection | DOAJ |
| description | Preoperative identification of the Adamkiewicz artery (AKA) with adequate reconstruction or preservation during surgery is useful for protecting the spinal cord from ischemia during thoracoabdominal aortic repair. However, the identification of the AKA remains challenging in some cases, especially with chronic aortic dissection. In a 45-year-old man with chronic aortic dissection requiring thoracoabdominal aortic repair, conventional contrast-enhanced CT or MR angiography failed to detect AKA due to the large entry tear and an enlarged false lumen. Intra-arterial ultra-high-resolution CT angiography combined with hemodynamic assessment using 4D flow MRI successfully identified the AKA, allowing for aortic repair with targeted intercostal artery reconstruction without postoperative signs of spinal cord ischemia. |
| format | Article |
| id | doaj-art-bf50877be51f4afd86935b75ac5505ce |
| institution | Kabale University |
| issn | 1930-0433 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj-art-bf50877be51f4afd86935b75ac5505ce2025-01-18T05:04:05ZengElsevierRadiology Case Reports1930-04332025-03-0120315811585Identification of Adamkiewicz artery by 4D flow MRI and intra-arterial ultra-high-resolution CT angiography in preoperative assessment of patients with chronic aortic dissection: A case reportSatoshi Higuchi, MD, PhD0Yuta Sato, MD1Hideki Ota, MD, PhD2Ryuichi Mori, RT3Yuki Ichinoseki, RT4Hitoshi Nemoto, RT5Shingo Kayano, RT6Kiichiro Kumagai, MD, PhD7Yoshikatsu Saiki, MD, PhD8Kei Takase, MD, PhD9Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Miyagi, Japan; Corresponding author.Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Miyagi, JapanDepartment of Diagnostic Radiology, Tohoku University Hospital, Sendai, Miyagi, JapanDepartment of Radiological Technology, Tohoku University Hospital, Sendai, Miyagi, JapanDepartment of Radiological Technology, Tohoku University Hospital, Sendai, Miyagi, JapanDepartment of Radiological Technology, Tohoku University Hospital, Sendai, Miyagi, JapanDepartment of Radiological Technology, Tohoku University Hospital, Sendai, Miyagi, JapanDepartment of Cardiovascular Surgery, Tohoku University Hospital, Sendai, Miyagi, JapanDepartment of Cardiovascular Surgery, Tohoku University Hospital, Sendai, Miyagi, JapanDepartment of Diagnostic Radiology, Tohoku University Hospital, Sendai, Miyagi, JapanPreoperative identification of the Adamkiewicz artery (AKA) with adequate reconstruction or preservation during surgery is useful for protecting the spinal cord from ischemia during thoracoabdominal aortic repair. However, the identification of the AKA remains challenging in some cases, especially with chronic aortic dissection. In a 45-year-old man with chronic aortic dissection requiring thoracoabdominal aortic repair, conventional contrast-enhanced CT or MR angiography failed to detect AKA due to the large entry tear and an enlarged false lumen. Intra-arterial ultra-high-resolution CT angiography combined with hemodynamic assessment using 4D flow MRI successfully identified the AKA, allowing for aortic repair with targeted intercostal artery reconstruction without postoperative signs of spinal cord ischemia.http://www.sciencedirect.com/science/article/pii/S1930043324013694Spinal cord ischemiaAdamkiewicz arteryChronic aortic dissectionFour-dimensional flow MRIIntra-arterial CT angiography |
| spellingShingle | Satoshi Higuchi, MD, PhD Yuta Sato, MD Hideki Ota, MD, PhD Ryuichi Mori, RT Yuki Ichinoseki, RT Hitoshi Nemoto, RT Shingo Kayano, RT Kiichiro Kumagai, MD, PhD Yoshikatsu Saiki, MD, PhD Kei Takase, MD, PhD Identification of Adamkiewicz artery by 4D flow MRI and intra-arterial ultra-high-resolution CT angiography in preoperative assessment of patients with chronic aortic dissection: A case report Radiology Case Reports Spinal cord ischemia Adamkiewicz artery Chronic aortic dissection Four-dimensional flow MRI Intra-arterial CT angiography |
| title | Identification of Adamkiewicz artery by 4D flow MRI and intra-arterial ultra-high-resolution CT angiography in preoperative assessment of patients with chronic aortic dissection: A case report |
| title_full | Identification of Adamkiewicz artery by 4D flow MRI and intra-arterial ultra-high-resolution CT angiography in preoperative assessment of patients with chronic aortic dissection: A case report |
| title_fullStr | Identification of Adamkiewicz artery by 4D flow MRI and intra-arterial ultra-high-resolution CT angiography in preoperative assessment of patients with chronic aortic dissection: A case report |
| title_full_unstemmed | Identification of Adamkiewicz artery by 4D flow MRI and intra-arterial ultra-high-resolution CT angiography in preoperative assessment of patients with chronic aortic dissection: A case report |
| title_short | Identification of Adamkiewicz artery by 4D flow MRI and intra-arterial ultra-high-resolution CT angiography in preoperative assessment of patients with chronic aortic dissection: A case report |
| title_sort | identification of adamkiewicz artery by 4d flow mri and intra arterial ultra high resolution ct angiography in preoperative assessment of patients with chronic aortic dissection a case report |
| topic | Spinal cord ischemia Adamkiewicz artery Chronic aortic dissection Four-dimensional flow MRI Intra-arterial CT angiography |
| url | http://www.sciencedirect.com/science/article/pii/S1930043324013694 |
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