Department of Radiology, University Hospitals Coventry and Warwickshire National Health Service (NHS) Trust, Coventry, England.
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.
Chest. 2013 Mar;143(3):634-639. doi: 10.1378/chest.12-1285.
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.
传统观点认为肋间动脉在上方肋骨的肋沟中受到保护。然而，在大量活体动脉中，尚未对肋间动脉的连续行程和变异性以及可能影响其行程和变异性的因素进行描述。
通过 CT 肺动脉造影生成冠状位最大密度投影重建图像，以确定肋间动脉（第 7 至 11 肋间隙）的后外侧行程。采用新型半自动计算机分割算法测量在肋间隙中暴露的肋上缘下边界、肋下缘上边界与肋间动脉位置之间的距离。分析动脉的位置和变异性与临床因素之间的关系。
分析了 47 例患者的 298 支动脉。在肋间隙中暴露的动脉在脊柱外侧的平均横向距离为 39 毫米，变异性较大（标准差为 10 毫米；第 10 百分位数至第 90 百分位数为 28-51 毫米）。在距脊柱 3 厘米的外侧距离处，有 17%的动脉被上方肋骨遮蔽，而在 6 厘米处这一比例为 97%。暴露的动脉长度与年龄、性别、肋间隙或侧别无关。动脉位置的变异性与年龄（系数为 0.91；P <.001）和肋间隙数（系数为-2.60；P <.001）显著相关。
肋间动脉在脊柱外侧 6 厘米范围内的肋间隙内暴露。其垂直位置的变异性在年龄较大的患者和更头侧的肋间隙中更大。
