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Thoracodorsal artery

The thoracodorsal artery is a terminal branch of the subscapular artery, itself a branch of the axillary artery. It arises near the lower border of the subscapularis muscle and courses downward and laterally along the posterior axillary wall to reach and supply the latissimus dorsi muscle, as well as parts of the teres major and serratus anterior muscles. It travels with the thoracodorsal vein and thoracodorsal nerve within the neurovascular bundle. The artery is clinically important because it is frequently used as a pedicle in musculocutaneous flaps for breast reconstruction and chest wall surgery.

Synonyms

  • Arteria thoracodorsalis

  • Latissimus dorsi artery

  • Subscapular branch to latissimus

Function

  • Provides the primary vascular supply to the latissimus dorsi muscle

  • Contributes branches to the teres major and serratus anterior muscles

  • Plays a key role in surgical flaps for breast and thoracic wall reconstruction

  • Maintains collateral circulation in the axillary region

MRI Appearance

T1-weighted images:

  • Vessel lumen appears as a signal void (black) due to flowing blood

  • Surrounded by hyperintense fat of the axillary region, aiding visualization

  • Vessel wall is seen as a thin hypointense rim

T2-weighted images:

  • Flowing blood continues to show signal void

  • Adjacent edema, inflammation, or mass lesions may appear hyperintense, displacing or encasing the artery

STIR (Short Tau Inversion Recovery):

  • Suppresses surrounding fat, improving contrast between the artery and adjacent soft tissues

  • Pathological changes (e.g., inflammatory or postoperative changes) appear hyperintense, while artery remains a flow void

T1 Post-Contrast (Gadolinium-enhanced):

  • Thoracodorsal artery enhances brightly and homogeneously

  • Clearly delineates the artery within the axillary neurovascular bundle

  • Particularly useful in preoperative planning for flap surgery or vascular pathology

CT Appearance

Non-contrast CT:

  • Artery appears as a small tubular soft tissue structure in the posterior axillary wall, usually not well defined without contrast

  • Surrounding fat provides natural contrast, but lumen remains indistinct

CT Angiography (CTA):

  • Provides excellent visualization of the artery from its origin at the subscapular artery to its termination in the latissimus dorsi muscle

  • Contrast opacifies the lumen, allowing evaluation for stenosis, occlusion, trauma, or surgical planning

  • Multiplanar reconstructions (axial, coronal, sagittal) highlight its course alongside the thoracodorsal vein and nerve

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Thoracodorsal artery anatomy CT axial image -img-00000-00000

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Thoracodorsal artery anatomy MRI coronal image -img-00000-00000