Key Points for Reading Chest CT Scans – July 10, 2002

Key Points for Reading Chest CT Scans – July 10, 2002

1. Apical level (second thoracic vertebra) The trachea, blood vessels, and the common carotid arteries on both sides of the vertebral column, as well as the subclavian arteries and veins, form a triangular shape.

2. Supra-aortic level (third thoracic vertebra) The trachea, esophagus, and the brachiocephalic venous plexus, brachiocephalic artery, and head veins on the right side occupy a large area in the front right. On the left side remain the left common carotid artery and the left subclavian artery.

3. Aortic arch level (fourth thoracic vertebra) The trachea, esophagus, vertebral column, and fat tissue behind the sternum. The upper right front features the aortic arch, the upper left is the superior vena cava, and the small vessels on either side of the vertebral column are the intercostal veins.

4. Subarch level (sixth thoracic vertebra) The trachea, esophagus, and vertebral column—front holds the large ascending aorta, back the larger descending aorta, the upper right is the superior vena cava, and the intercostal veins are beside the vertebral column.

5. Tracheal bifurcation level The trachea splits into two (black holes), behind the esophagus and vertebral column. Besides the aforementioned ascending and descending aortas, there is the anterior mediastinal gland behind the sternum, and one can also see the left pulmonary artery in front of the trachea, the azygos vein behind the vena cava, and the intercostal veins in the vertebral column.

6. Pulmonary artery level (seventh thoracic vertebra) From the trachea, esophagus, and vertebral column, besides the previously mentioned ascending and descending aortas, one can also see the left and right branches of the pulmonary artery in between, and the intercostal veins on the left side of the vertebral column.

7. Heart level (eighth thoracic vertebra) The characteristic of this level is that the vertebral column is centered on the aortic root in the front, with the right atrium on the right side, and proceeding clockwise: right atrium → right ventricle → left ventricle → left atrium in a loop. In front of the right ventricle, the right coronary artery is on the right, and the left coronary artery is on the left.