The Initial Exploration of Adamkiewicz Artery Computed Tomographic Angiography With Monochromatic Reconstruction of Gemstone Spectral Imaging

The study aimed to explore whether optimal monochromatic reconstruction can improve the depiction of the Adamkiewicz artery (AKA) on gemstone spectral computed tomographic angiography (GSCTA) compared with the polychromatic reconstruction protocol. The prospective study was approved by the ethics committee, and written informed consent was obtained from each patient. The 58 consecutive patients suspected of aortic aneurysm or dissection underwent aortic GSCTA. All images were reconstructed with both polychromatic (group A) and optimal monochromatic (group B) protocol. The CT values of the descending aorta and muscle, background noise, and the contrast-to-noise ratio were measured and calculated. With the criterion standard display of AKA, characteristic hairpin curve sign, 2 blinded radiologists analyzed data independently with the paired samples t, χ, and Mann-Whitney U test. The CT value of the descending aorta and the contrast-to-noise ratio of group B were significantly superior to group A (t = 12.7, P < 0.01; t = 15.2, P < 0.01). The visual rate of AKA (94.8%) in group B was significantly higher (χ = 4.2, P = 0.04) than group A (82.8%). Using a 5-point scale to assess, the score of the visualization efficiency of group B (226) was significantly higher (Z = -2.4, P = 0.02) than group A (192). The optimal monochromatic reconstruction for GSCTA can improve the visualization efficiency and quality of the AKA compared with the polychromatic reconstruction protocol.