vascular structue of thorax and abdomen . It is very use full for Radiographers.

1. Vascular structure
Thorax and Abdomen
Almas Khan
Radiology Technologist
Khorfakhan Hospital

2. Vascular structure Thorax and
Abdomen
Talk plan:-
 Vascular system and Circulations
 Co relation with Anatomical landmark
 Common Indications.

3. Components of circulatory system
Circulatory system
Cardiovascular Lymphatic system
Cardio Vascular Lymph
(heart) (vessels) Lymph vessels
Lymphatic nodules
Pulmonary Systemic
( lung) ( body)
The circulatory system consists of cardiovascular and lymphatic components
.
The cardiovascular portion includes heart, blood , and vessels that
Transport the blood.

5. Blood vessels
• Arteries: carry blood away
from the heart
Arterioles – smallest
arteries , carrying blood
to tissue.
• Veins: carry blood back to
the heart
• Venules – smallest vein ,
returning blood from tissue.
• Capillaries: microscopic
blood vessels .

6. Aorta
Four segments of Aorta
1) Aortic bulb ( root )
2) Ascending aorta
3) Ascending arch
4) Descending aorta.
Branches of Arch of Aorta :-
1) Brachiocephalic artery
2 ) Left common carotid artery
3) Left subclavian artery

7. Vascular structure Head and neck

8. Thoracic Aorta and major branches
• The thoracic aorta begins at the level of vertebra T5 and
continue through to the diaphragm at the level of T12.
• Initially traveling within the mediastinum to the left of
vertebral column , as it passes through the thoracic region.

9. Thoracic aorta branches :
Visceral branches : Supply blood primarily to visceral organs of
thorax
• Bronchial artery
• Esophageal artery
• Pericardial artery
• Mediastinal artery
Parietal (somatic ) branches : blood to the muscles of thoracic
cavity and vertebral column
• Intercostal artery
• Superior phrenic artery.

10. Thoracic aorta branches :
• Each bronchial artery supplies systemic blood to the lung and
visceral pleura.
• Each pericardial artery supplies blood to the pericardium.
• Esophageal artery provides blood to the esophagus
• Mediastinal artery provides blood to the mediastinum.
• Each intercostal artery provides blood to the muscles of the
thoracic cavity and vertebral column.
• Superior phrenic artery provides blood to the superior surface
of the diaphram.

12. Abdominal Aorta and Major branches
• After crossing through the diaphragm at the aortic hiatus, the
thoracic aorta is called abdominal aorta.
• It formally ends at the level of L4 vertebra.
• It bifurcates to form the common iliac arteries.
• Abdomen aorta gives rise to several important branches.

13. • Celiac trunk:-
Also called celiac artery
a major branch of abdomen
aorta , gives rise to the gastric
artery , splenic artery , and
common hepatic artery that
forms the hepatic artery to the
liver
The right artery to the
stomach , cystic artery to the
gall bladder.
CHA: common hepatic artery; CT: celiac trunk; GDA:
gastroduodenal artery; LGA: left gastric artery; LHA: left
hepatic artery; RHA: right hepatic artery; SA: splenic
artery; SMA: superior mesenteric artery

14. Abdomen aorta Branches…..
• Left gastric artery : Branch of
celiac trunk ; supply blood to
stomach.
• Splenic artery : Branch of celiac
trunk ; supply blood to the
spleen.
• Common hepatic artery (CHA) :
Br of celiac trunk that forms the
hepatic artery, right gastric artery
and cystic artery.
• Hepatic artery proper : Br of CHA
; supplies systemic blood to the
liver.
• Right gastric artery : Br of CHA ;
supplies blood to the stomach.
• Cystic artery : Br of CHA ; supplies
blood to the gall bladder .

16. • Superior mesenteric artery : Br of
abdominal aorta ; suppilies blood
to the small intestine (duodenum,
jejunum, ileum) , pancreases and
a majority of the large intestine.
• Inferior meseneteric artery:
supplies blood to the distal
segment of the large intestine
and rectum.
• Inferior phrenic artery : supplies
blood to the inferior surface of
diaphragm.

17. • Adrenal artery: Br of
abdominal aorta ; supplies
blood to the adrenal
(suprarenal ) glands.
• Renal artery : Branches
approximately 2.5 cm inferior
to the superior mesenteric
arteries and supplies a kidney.
The right renal artery is longer
than the left since the aorta lies
to the left of vertebral column.

18. • Gonadal artery : Supplies blood
to the gonads ,or reproductive
organs.
• Lumbar arteries : Supply blood to
the lumbar region, the abdomen
wall , and the spinal cord.
• The aorta divided at the level of
vertebra L4 into left and right
Common iliac artery. But
continues as a small vessels , the
median sacral artery in to
sacrum.

20. • The common iliac arteries provides
blood to the pelvic region and lower
limbs
• They split into external and internal
iliac arteries.
• Internal iliac arteries: Supplies blood
to the urinary bladder , wall of pelvis
, external genitalia , medial portion of
the femoral region.
• External iliac artery: It leaves the
body cavity and become a femoral
artery, supplies blood to lower limbs

21. Thoracic vein
• The right atrium receives all of the systemic venous return.
• The major veins the chest are the superior vena cava , azygos and
pulmonary artery.
• Most of blood flow into either superior vena cava or inferior vena cava.
• Superior vena cava : Large systemic vein , blood from most areas superior
to the diaphragm , empties in to right atrium .

22. • Azygos vein : return blood
from posterior thoracic wall
to superior vena cava .
• The superior and inferior
pulmonary veins return
oxygenated blood from the
lungs to the left atrium.
• Inferior vena cava return
blood from the abdomen
and lower limbs to the right
atrium.

23. Abdominal veins
• Inferior vena cava : parallel the
abdominal aorta. Receives blood
from abdominal veins.
• This veins include the right and left
common iliacs , internal iliacs
external iliacs , renal veins and
hepatic portal systems.
• Superior and inferior mesenteric
veins return blood from the small
and large intestine through the
hepatic portal vein.
• Liver drains to each hepatic vein and
directly in inferior vena cava.

24. Tributaries Of The Inferior Vena Cava
Right
suprarenal vein
Right
gonadal vein
Hepatic veins
Inferior vena cava
External iliac
vein
Inferior phrenic
vein
Renal veins
Lumbar veins
Left ascending
lumbar vein
Left gonadal
vein
Common iliac
vein
Internal iliac
vein
Left suprarenal
vein

25. Major Branches Of The Abdominal Aorta
Adrenal
gland
Celiac trunk
Kidney
Abdominal
aorta
Diaphragm
Suprarenal
artery
Renal artery
Superior
mesenteric artery
Gonadal
artery
Inferior
mesenteric artery
Common iliac
artery

26. Hepatic portal system :
• Hepatic portal system :
• Contains substance absorbed
by the stomach and intestines
• Delivers these compounds to
the liver for
• Storage
• Metabolic conversion
• Excretion
• Nutrients from the digestive
tract enter the hepatic portal
vein

27. Tributaries of the
Hepatic Portal Vein
Inferior mesenteric vein:
drains part of large intestine
Splenic vein:
drains spleen, part of stomach, and pancreas
Superior mesenteric vein:
drains part of stomach, small intestine, and part of large
intestine
Left and right gastric veins:
drains part of stomach
Cystic vein:
drains gallbladder

28. Veins Of The Hepatic Portal System
Hepatic veins
Liver
Spleen
Gastric veins
Inferior vena cava
Splenic vein
Inferior
mesenteric vein
Superior
mesenteric vein
Large intestine
Hepatic portal vein
Small intestine
Rectum

29. The Hepatic Portal System
• A specialized part of the vascular circuit
• Picks up digested nutrients
• Delivers nutrients to the liver for processing

32. CT Angiogram
CT Angiography is a medical exam that combines a CT scan with
an injection of a contrast material to produce pictures of blood
vessels and tissue in a part of body.
CT Angiography to helps diagnose a narrowing or obstruction of
the arteries, an aneurysm, deep vein thrombosis, pulmonary
embolism, or other vascular condition.

33. MDCT angiography findings of the most common aortic diseases:
1. Congenital disorders
2. Inflammatory pathology
3. Aortic aneurysm
4. Complications of aortic aneurysm
- Rupture
- Impeding rupture
5. Acute aortic syndrome
- Aortic dissection
- Intramural hematoma
- Penetrating atherosclerotic ulcer
6. Traumatic injuries
7. Postsurgical complications

34. Locator position for Angiograms
Example of the regions of interest (ROIs) drawn on
the aorta (arrow) to obtain the CT values. ROI 1: Arch
of aorta at Th 7 level, ROI 2: abdominal aorta at L 1
level, and ROI 3: S 1 level.

35. CT Pulmonary Angiogram (CTA)
• localize the pulmonary trunk, which is
just at or below the level of the
bifurcation of the trachea (white lines).
• The resulting axial CT localization
image is shown on the right. An
elliptical ROI is placed in the right
pulmonary artery to measure the time
for contrast to reach this area from the
injection site.

36. CT Pulmonary Angiogram (CTA)
A picture of a heart model that displays the right atrium
(RA) that receives deoxygenated blood from the superior
vena cava (SVC). The blood then flows to the right
ventricle (RV)) and to the pulmonary trunk (PT). These
structures are also seen on the coronal CT image on the
right. Also labeled are the aorta (A) and left ventricle (LV).

37. CT Pulmonary Angiogram (CTA)
• These two axial CT images show
profound pulmonary emboli. On the
left the embolus almost completely
blocks the right pulmonary artery
(yellow arrow). Right image show an
extensive saddle embolus forming in
both pulmonary arteries and
becoming extensive. Both of these
types of pulmonary emboli are life
threatening and require immediate
medical attention.
Left- axial CT image demonstrate the
anatomical presentations of the
pulmonary trunk when normal in size,
caliber, and pressure (yellow arrow), and
on the right an example of a large
widened pulmonary trunk (pink arrow)
due to pulmonary hypertension.

38. MIP- and VRT-images:
steno-obstructive disease
Calcifications Aneurysms

39. CT Angiography
Aorta bolus tracking
time
CT Pulmonary study timing
• Post Inj delay : 7sec
• Post threshold : Automatic minimum
• Scan start time : 12 seconds
• HU :120 /150
• Locator : Just below the bifurcation
CT Abdomen bolus tracking timing
• Post Inj delay : 12
• Arterial : 18 to 20 seconds
• Portal venous phase : 70 sec
• Equilibrium : 120 sec
• CT KUB with Contrast
• Scan to start 5 to 10 mts from the start of Inj
• Post Inj delay : 8 sec
• Post threshold : 5 sec
• Scan start time : 15 sec
• HU : 120/150
• Locator : Arch of
aorta

40. Case Studies of
Radiology Department Khorfakhan Hospital

44. CONCLUSION
 We are able to understand how the circulation of blood is
organized in the thorax and Abdomen.
 Helps to identify vessels after injection of contrast.
 A good understanding of anatomy is essential while performing
angiography.
Normal and abnormal distribution of circulatory system
 Co relation with Anatomical landmark helps to identify vascular
structures of Thorax and Abdomen precisely .

45. Thanks for the motivation and guidance provided by our
Radiologists with out which we would not have achieved good
results.
Congrats and expecting continued best support from all my
colleagues.

46. Thank you