VERTEBRAL ARTERIES ON CT OF THE CHEST

Abstract

Introduction: Knowledge of the superior mediastinal course of the vertebral arteries is important for radiologists who evaluate chest CT, particularly in the setting of trauma, when planning a percutaneous interventional procedure or for pre-operative planning. Our aim was to determine how often the vertebral arteries could be identified on chest CT studies. Methods: Contrast enhanced chest CT studies from 50 consecutive patients were reviewed, with specific attention to the vertebral arteries in the superior mediastinal and thoracic outlet regions. Results: The average diameter of left vertebral artery was 3mm and it is seen in 43 of 50 (85%) patients. The average diameter of right vertebral artery was also 3mm and it is seen in 38 of 50 (76%) patients. Non-visualization of a vertebral artery was usually owing to proximal venous occlusion with extensive collateral vessels in the expected location of the vertebral arteries, local lymphadenopathy, poor contrast bolus technique or local beam hardening artifact. Conclusion: Radiologists need to alert surgeons planning for vascular surgery in the region of the vertebral arteries. It is also important to note that a left vertebral artery was not identified on chest CT in 15% of patients. KEY WORDS: Vertebral artery, CT scan, anatomy