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Normal variation of vertebral artery on CT angiography and its implications for diagnosis of acquired pathology

Pina C Sanelli1, Samuel Tong, R Gilberto Gonzalez

  • 1Department of Radiology, Massachusetts General Hospital, Boston, USA. sanellip@hotmail.com

Journal of Computer Assisted Tomography
|May 23, 2002
PubMed

Insights

Normal variations in vertebral artery size and position within the transverse foramen are significant. CT angiography (CTA) findings of vertebral artery pathology must account for this natural asymmetry.

Area of Science:

  • Radiology
  • Neuroimaging
  • Vascular Anatomy

Background:

  • Computed tomography angiography (CTA) is increasingly used for cerebrovascular disease evaluation.
  • Diagnosis of vertebral artery pathology via CTA often depends on assessing artery size and position relative to the transverse foramen.
  • Systematic descriptions of normal vertebral artery variations on CT are lacking.

Purpose of the Study:

  • To systematically describe the normal variations in vertebral artery size and position within the transverse foramen.
  • To establish a baseline for interpreting CTA findings related to vertebral artery pathology.
  • To inform the diagnostic accuracy of CTA in cerebrovascular disease assessment.

Main Methods:

  • Retrospective study of patients under 40 years old who underwent CTA for non-vertebral artery disease indications.
  • Three radiologists measured the area of the vertebral artery and the transverse foramen.
  • Variance component analysis was employed to quantify variations.

Main Results:

  • Significant variation exists in vertebral artery size relative to the transverse foramen, occupying 8-85% of its area.
  • Marked asymmetry in relative vertebral artery size and position was frequently observed.
  • Intra-patient, level-to-level variability in asymmetry was also noted.

Conclusions:

  • Vertebral artery dimensions and location within transverse foramina exhibit considerable normal variation in young individuals.
  • These anatomical variations are crucial considerations when interpreting CT angiograms for potential vertebral artery pathology.
  • Awareness of normal variation enhances the diagnostic reliability of CTA in cerebrovascular assessments.
Abstract

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