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Course and variation of the intercostal artery by CT scan.

Authors
  • Helm, Emma J1
  • Rahman, Najib M2
  • Talakoub, Omid3
  • Fox, Danial L4
  • Gleeson, Fergus V5
  • 1 Department of Radiology, University Hospitals Coventry and Warwickshire National Health Service (NHS) Trust, Coventry, England.
  • 2 Oxford Centre for Respiratory Medicine and Oxford Pleural Diseases Unit, Churchill Hospital, Oxford, England; National Institute of Health Research (NIHR) Oxford Biomedical Research Centre, University of Oxford, Oxford, England.
  • 3 Department of Electrical and Computer Engineering, University of Toronto, Toronto, ON, Canada. , (Canada)
  • 4 Department of Radiology, Taunton and Somerset NHS Foundation Trust, Taunton, England.
  • 5 National Institute of Health Research (NIHR) Oxford Biomedical Research Centre, University of Oxford, Oxford, England; Department of Radiology, Oxford Radcliffe NHS Trust, Churchill Hospital, Oxford, England. Electronic address: [email protected]
Type
Published Article
Journal
CHEST Journal
Publisher
Elsevier
Publication Date
Mar 01, 2013
Volume
143
Issue
3
Pages
634–639
Identifiers
DOI: 10.1378/chest.12-1285
PMID: 23079732
Source
Medline
Language
English
License
Unknown

Abstract

It is conventionally taught that the intercostal artery is shielded in the intercostal groove of the superior rib. The continuous course and variability of the intercostal artery, and factors that may influence them, have not been described in a large number of arteries in vivo. Maximal intensity projection reformats in the coronal plane were produced from CT scan pulmonary angiograms to identify the posterolateral course of the intercostal artery (seventh to 11th rib spaces). A novel semiautomated computer segmentation algorithm was used to measure distances between the lower border of the superior rib, the upper border of the inferior rib, and the position of the intercostal artery when exposed in the intercostal space. The position and variability of the artery were analyzed for association with clinical factors. Two hundred ninety-eight arteries from 47 patients were analyzed. The mean lateral distance from the spine over which the artery was exposed within the intercostal space was 39 mm, with wide variability (SD, 10 mm; 10th-90th centile, 28-51 mm). At 3 cm lateral distance from the spine, 17% of arteries were shielded by the superior rib, compared with 97% at 6 cm. Exposed artery length was not associated with age, sex, rib space, or side. The variability of arterial position was significantly associated with age (coefficient, 0.91; P < .001) and rib space number (coefficient, - 2.60; P < .001). The intercostal artery is exposed within the intercostal space in the first 6 cm lateral to the spine. The variability of its vertical position is greater in older patients and in more cephalad rib spaces.

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