MRA of the Adamkiewicz artery: a preoperative study for thoracic aortic aneurysm

PURPOSE: The purpose of this work was to investigate the ability of MR angiography (MRA) to visualize the Adamkiewicz artery (AKA) as a preoperative study of thoracic aortic aneurysm to prevent ischemic injury of the spinal cord. METHOD: Twenty-six patients scheduled for surgical or endovascular stent-graft repair of thoracic aortic aneurysm were studied with a three-dimensional contrast MRA. Data acquisition was repeated two times following injection of Gd-DTPA. Source images were processed with multiplanar reconstruction and maximum intensity projection. RESULTS: The AKA was identified in 69% (18/26). In three patients, selective angiography of the intercostal artery confirmed the AKA at the same level and side predicted by MRA. The anterior spinal artery and the anterior medullary vein were observed in 50% (13/26) and 65% (17/26), respectively. CONCLUSION: Contrast MRA is a promising technique to visualize the AKA noninvasively as a preoperative evaluation of thoracic aortic aneurysms.