High false-negative rate of the anterior spinal artery by intercostobronchial trunk arteriography alone compared to CT during arteriography

Br J Radiol. 2021 Jul 1;94(1123):20210402. doi: 10.1259/bjr.20210402. Epub 2021 Jun 11.

Abstract

Objectives: This study aimed to assess the frequencies of the anterior spinal arteries identified by CT during arteriography (CTA) and arteriography alone.

Methods: This retrospective study included 137 vessels in 83 patients who performed both bronchial arteriography and CTA and categorized them into three groups based on the catheter tip locations: intercostobronchial trunk (ICBT), bronchial artery (BA), and intercostal artery (ICA). The frequencies of anterior spinal artery identified by CTA and arteriography alone were compared for each group.

Results: ICBT, BA, and ICA groups were evaluated by CTA in 46, 79, and 12 vessels, respectively. By CTA evaluation, anterior spinal artery was identified in seven vessels (15.2%) in ICBT group, 0 in BA group and two (16.7%) in ICA group. The frequencies of anterior spinal artery were significantly higher (p < 0.05) in ICBT and ICA groups than in BA group. By arteriography evaluation alone, a faint anterior spinal artery was identified in two vessels (4.3%) in ICBT group, 0 in BA group, and 1 (8.3%) in ICA group.

Conclusions: Anterior spinal artery branched only from the ICBT or ICA and not from the BA in both arteriography and CTA assessments. There was high false-negative rate (71%) of the anterior spinal artery by ICBT arteriography alone assessment compared to CTA assessment. This result explains one of the reasons that spinal ischemia occurs in arteriography-negative spinal artery cases.

Advances in knowledge: False-negative rate of anterior spinal artery was 71% (5/7) by intercostobronchial trunk arteriography alone assessment.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Angiography*
  • Bronchial Arteries / diagnostic imaging*
  • False Negative Reactions
  • Female
  • Hemoptysis / diagnostic imaging
  • Humans
  • Lung Neoplasms / diagnostic imaging
  • Male
  • Middle Aged
  • Retrospective Studies
  • Spine / blood supply*
  • Thoracic Arteries / diagnostic imaging*
  • Tomography, X-Ray Computed*