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Demonstration of the Adamkiewicz artery in patients with descending or thoracoabdominal aortic aneurysm: optimization of contrast-medium application for 64-detector-row CT angiography

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Abstract

Our aim was to prospectively investigate the contrast agent concentration and the infusion rate to obtain optimal images of the Adamkiewicz artery by 64-row MDCT. Eighty patients were divided into four groups based on the following protocol: A, 100 mL of 300 mg I/mL at 5.0 mL/s; B, 100 mL of 350 mg I/mL at 5.0 mL/s; C, 100 mL of 300 mg I/mL at 3.5 mL/s; D, 100 mL of 350 mg I/mL at 3.5 mL/s. Quantitative evaluation was performed by calculating mean aortic attenuation value from T5 to L3 level. Visual evaluation of the Adamkiewicz artery was also performed. In a quantitative evaluation, the rapid injection (A, 473.4 ± 82.6 HU; B, 506.7 ± 71.9 HU) was significantly superior to the slow injection (C, 371.3 ± 65.1 HU; D, 391.5 ± 60.8 HU). In a visual evaluation, the Adamkiewicz artery was assessable in 15 of 20 (75%), 16 of 20 (80%), 9 of 20 (45%), and 10 of 20 (50%) patients in groups A, B, C, and D, respectively. The injection protocol of 1.75 g iodine/s provides both the adequate aortic attenuation of more than 450 HU to assess the Adamkiewicz artery and the best visualization of the Adamkiewicz artery in 64-row MDCT.

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Authors and Affiliations

  1. Diagnostic Imaging Center, Saiseikai Kumamoto Hospital, 5-3-1 Chikami, Kumamoto-shi, Kumamoto, 861-4193, Japan

    Daisuke Utsunomiya, Syuichiro Okumura & Joji Urata

  2. Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto-shi, Kumamoto, 860-0811, Japan

    Yasuyuki Yamashita

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  1. Daisuke Utsunomiya
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  2. Yasuyuki Yamashita
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  3. Syuichiro Okumura
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  4. Joji Urata
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Correspondence to Daisuke Utsunomiya.

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Utsunomiya, D., Yamashita, Y., Okumura, S. et al. Demonstration of the Adamkiewicz artery in patients with descending or thoracoabdominal aortic aneurysm: optimization of contrast-medium application for 64-detector-row CT angiography. Eur Radiol 18, 2684–2690 (2008). https://doi.org/10.1007/s00330-008-1036-4

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  • DOI: https://doi.org/10.1007/s00330-008-1036-4

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