Frédéric Clarençon1,2, Federico Di Maria3, Nader-Antoine Sourour3, Joseph Gabrieli3,4, Aurélien Nouet5, Eimad Shotar3, Evelyne Cormier3, Robert Fahed3, Philippe Cornu4,5, Jacques Chiras3,4. 1. Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, 47, Bd de l'Hôpital, 75013, Paris, France. fredclare5@msn.com. 2. Paris VI University, Pierre et Marie Curie University, Paris, France. fredclare5@msn.com. 3. Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, 47, Bd de l'Hôpital, 75013, Paris, France. 4. Paris VI University, Pierre et Marie Curie University, Paris, France. 5. Department of Neurosurgery, Pitié-Salpêtrière Hospital, Paris, France.
Abstract
PURPOSE: To evaluate the performances of the CT-angiography by direct intra-aortic contrast media injection (IA-CTA) for spinal vascular malformations (SVMs)' imaging. MATERIALS AND METHODS: Thirteen patients (8 males, 5 females, mean age: 56 y) with suspected SVM underwent IA-CTAs by direct intra-aortic iodinated contrast media injection (5 cc/s; 100 cc) via an arterial femoral or humeral access. Two independent observers evaluated the angioarchitecture of the SVMs and the visualisation of both the Adamkiewicz artery and the anterior spinal artery. Then a consensus was obtained between the 2 reviewers; the results of the IA-CTA were finally compared with those of the full spinal DSA evaluated in consensus. RESULTS: The IA-CTA was feasible in all cases and depicted the SVM in all except one case (92 %). Interrater agreement was good for the location of the SVMs' level. Intermodality (IA-CTA/DSA) agreement was excellent for the level and side of the shunt point, as well as for the SVM subtype evaluation. In 77 % of the cases, the Adamkiewicz artery was satisfactorily seen at the same time on IA-CTA. CONCLUSION: IA-CTA is a new technique that seems helpful to reach a better understanding of SMVs and may help to tailor more precisely their treatment. KEY POINTS: • IA-CTA is an accurate technique for the SVMs' angioarchitecture analysis • IA-CTA can locate, at the same time, the Adamkiewicz artery (AKA) • IA-CTA may be helpful in elderly patients with troublesome vasculature.
PURPOSE: To evaluate the performances of the CT-angiography by direct intra-aortic contrast media injection (IA-CTA) for spinal vascular malformations (SVMs)' imaging. MATERIALS AND METHODS: Thirteen patients (8 males, 5 females, mean age: 56 y) with suspected SVM underwent IA-CTAs by direct intra-aortic iodinated contrast media injection (5 cc/s; 100 cc) via an arterial femoral or humeral access. Two independent observers evaluated the angioarchitecture of the SVMs and the visualisation of both the Adamkiewicz artery and the anterior spinal artery. Then a consensus was obtained between the 2 reviewers; the results of the IA-CTA were finally compared with those of the full spinal DSA evaluated in consensus. RESULTS: The IA-CTA was feasible in all cases and depicted the SVM in all except one case (92 %). Interrater agreement was good for the location of the SVMs' level. Intermodality (IA-CTA/DSA) agreement was excellent for the level and side of the shunt point, as well as for the SVM subtype evaluation. In 77 % of the cases, the Adamkiewicz artery was satisfactorily seen at the same time on IA-CTA. CONCLUSION: IA-CTA is a new technique that seems helpful to reach a better understanding of SMVs and may help to tailor more precisely their treatment. KEY POINTS: • IA-CTA is an accurate technique for the SVMs' angioarchitecture analysis • IA-CTA can locate, at the same time, the Adamkiewicz artery (AKA) • IA-CTA may be helpful in elderly patients with troublesome vasculature.
Authors: S Oda; D Utsunomiya; T Hirai; Y Kai; Y Ohmori; Y Shigematsu; Y Iryo; H Uetani; M Azuma; Y Yamashita Journal: AJNR Am J Neuroradiol Date: 2013-08-01 Impact factor: 3.825