Low-tube-voltage CT assessment of Adamkiewicz artery: precise comparison between 100-kVp- and 120-kVp protocols

Publication date: Available online 14 December 2018

Source: European Journal of Radiology

Author(s): Yoshihiro Kubota, Hajime Yokota, Hiroki Mukai, Takuro Horikoshi, Joji Ota, Yasuaki Okafuji, Hideki Ueda, Goro Matsumiya, Takashi Uno

Abstract

Purpose

Preoperative identification of Adamkiewicz artery (AKA) for preventing postoperative spinal cord ischemia is still challenging because of its small diameter. Low-tube-voltage technique might improve the delineation of AKA due to its higher contrast enhancement and contrast-to-noise ratio (CNR). Our purpose was to evaluate the usefulness of low-tube-voltage CTA in visualization of AKA compared with the conventional voltage protocol on the condition with the same imaging parameters aside from tube voltage.

Methods

Eighty-three patients undergoing CTA for the evaluation of aorta were retrospectively included. All CTA was performed with 320-detector-row CT with the tube voltage of either 100-kVp (41 patients) or 120-kVp (42 patients). The CNR, CT value of aorta and objective image noise were assessed. Visualization of AKA was evaluated based on the continuity from aorta using the four-grade score by two independent reviewers. The estimated radiation dose (volumetric CT dose index) was also compared.

Results

The 100-kVp group showed significantly higher CNR and CT value than 120-kVp protocol (P =  0.010 and < 0.001, respectively). The visual score was also significantly higher in 100-kVp group than in 120-kVp group (2.73 ± 0.98 and 2.02 ± 1.00, respectively; P =  0.002). There was no significant difference on objective image noise and radiation dose between the groups (P =  0.24 and 0.72, respectively).

Conclusion

CTA with low-tube-voltage was significantly more sensitive for AKA visualization than conventional voltage protocol.

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