Identification of vertebral arteries on CT of the chest

Knowledge of the superior mediastinal course of the vertebral arteries is i mportant for radiologists who evaluate chest CT, particularly in the settin g of trauma, when planning a percutaneous interventional procedure or for p re-operative planning. Our aim was to determine how often the vertebral art eries could be identified on chest CT studies. Contrast enhanced chest CT s tudies from 100 consecutive patients were reviewed, with specific attention to the vertebral arteries in the superior mediastinal and thoracic outlet regions. The left vertebral artery was identified in 85 patients and the ri ght vertebral artery in 76 patients. Non-visualization of a vertebral arter y was usually owing to proximal venous occlusion with extensive collateral vessels in the expected location of the vertebral arteries, local lymphaden opathy. pour contrast bolus technique or local beam hardening artefact. Rad iologists: need to alert surgeons planning resection of mass lesions in thi s region to the location of the vertebral arteries. It is also important to note that a vertebral artery was not identified on chest CT in 24% of pati ents.