Junko Nishida, Abstract Co-Author: Nothing to Disclose

Kakuya Kitagawa MD, PhD, Presenter: Nothing to Disclose

Motonori Nagata MD, PhD, Abstract Co-Author: Nothing to Disclose

Akio Yamazaki RT, Abstract Co-Author: Nothing to Disclose

Naoki Nagasawa RT, Abstract Co-Author: Nothing to Disclose

Hajime Sakuma MD, Abstract Co-Author: Departmental Research Grant, Siemens AG Departmental Research Grant, Koninklijke Philips Electronics NV Departmental Research Grant, General Electric Company Departmental Research Grant, Bayer AG Departmental Research Grant, Eisai Co, Ltd Departmental Research Grant, Guerbet SA

In spite of the advancement of multi-detector row computed tomography (MDCT) technology, non-invasive detection of Adamkiewicz artery using MDCT is still very challenging especially in patients with aortic diseases. The purpose of this study was to investigate if model based iterative reconstruction (MBIR) can improve MDCT assessment of the Adamkiewicz artery by comparing with adaptive statistical iterative reconstruction (ASIR) and filtered back projection (FBP).

This study was performed in thirty-three patients who underwent contrast enhanced 64-slice MDCT for the assessment of aortic aneurysm or dissection. The helical data were reconstructed using FBP, ASIR and MBIR (Veo). Signal-to-noise ratio (SNR) of the aorta and contrast-to-noise (CNR) of the anterior spinal artery relative to the spinal cord were measured on multiplanar reformation images. Visualization of the Adamkiewicz artery and its continuity with the intercostal or lumbar artery were evaluated by consensus of two radiologists using a 4 point scale (1: not visible; 2: visible but branching level is unknown, 3: visible with continuous delineation from the intercostal artery except at the intervertebral foramen, 4: visible and full length of the arterial course is traceable).

MBIR showed significantly improved SNR of the aorta (33.7±5.6) and CNR of the anterior spinal artery (4.1±1.7) in comparison with those by ASIR (19.9±5.0 and 2.8±1.0) and FBP (14.6±3.2 and 2.6±0.9) (p<0.001 for all comparisons). The visualization score of the Adamkiewicz artery was also significantly improved by using MBIR (3.0±1.0) as compared with those by ASIR (2.4±1.2, p=0.001) and FBP (2.3±1.2, p<0.001). As a result, the level and the side from which the Adamkiewicz artery originated was identified in 85% (28/33) of the patients by using MBIR compared with 52%(17/33) and 39%(13/33) of the patients, respectively, by using ASIR and FBP.

The MBIR algorithm improved the MDCT visualization of the Adamkiewicz artery when compared with ASIR and FBP. This reconstruction method may therefore be helpful in planning surgical or endovascular treatment of aortic diseases.

MBIR dramatically improved the detection rate of the branching level of Adamkiewicz artery in patients with aortic aneurysm or dissection.

Nishida, J, Kitagawa, K, Nagata, M, Yamazaki, A, Nagasawa, N, Sakuma, H, Usefulness of Model Based Iterative Reconstruction in the MDCT Assessment of the Adamkiewicz Artery.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12031849.html