Variants and Anomalies of Thoracic Vasculature on Computed Tomographic Angiography in Adults

Netanel S. Berko, MD, Vineet R. Jain, MD, Alia Godelman, MD, Evan G Stein, MD, PhD, Subha Ghosh, MD, and Linda B. Haramati, MD, MS

Objective: To determine the prevalence and clinical significance of normal, variant, and anomalous branching patterns of the aortic arch and the central veins on computed tomographic (CT) angiography in adults.

Methods: We retrospectively reviewed 1000 consecutive CT angio�grams of the chest in 658 women and 342 men with a median age of 53 years.

Results: A total of 65.9% of patients had both normal aortic arch branching patterns and normal venous anatomy. Variants in the aortic arch branching pattern were present in 32.4% and anomalies in 1.5%. Venous anomalies were present in 0.7%. Review of CT reports showed � that cardiothoracic radiologists correctly reported the anomaly more frequently than other radiologists (94% vs 20%, P = 0.003).

Conclusions: Whereas anomalies of the central thoracic vasculature are uncommon, variants in the aortic arch branching pattern are com mon. An appreciation of the appearance of these entities on CT angiog� raphy allows for precise/ reporting and is useful in preprocedure planning.