Imaging Anatomy of the Mediastinum - Learning - Home
Imaging Anatomy of the Mediastinum Dr. Flip Otto Dept. of Radiology Universitas Academic Hospital Outline Mediastinal devisions Content of mediastinum
Mediastinal contours on PA chest radiograph Cross sectional anatomy of mediastinum Mediastinal lines and stripes on conventional radiography and CT correlation Mediastinal spaces Mediastinal lymphnodes Mediastinal devisions Devisions used to describe location of
pathological processes: Superior mediastinum: Above line from lower border T4 to sternal angle Anterior mediastinum: Between anterior part of heart and sternum
Middle mediastinum: Occupied by heart and its vessels Posterior mediastinum: Between posterior part of heart and thoracic spine Mediastinal contents
Mediastinal contours on PA chest radiograph Cross sectional Anatomy on CT T3 level 4 3 56 1 7 2
1 5 1-descending aorta 2-fundus of stomach 3-inferior vena cava 4-oesophago-gastric junction 5-spleen Mediastinal lines and stripes- Correlation
between plain chest radiography and CT Lines: Anterior junction line Posterior junction line Stripes:
Right paratracheal stripe Left paratracheal stripe Posterior tracheal stripe Posterior wall of bronchus intermedius Interfaces:
Right paraspinal line Left paraspinal line Aortic-pulmonary stripe Azygo-oesophageal recess Anterior junction line Abnormal anterior junction line
Volume loss in right lung with rightward displacement of anterior junction line following a right middle lobectomy Posterior junction line Right paratracheal stripe Abnormal right paratracheal stripe
Widening of right paratracheal stripe caused by a large ectopic parathyroid adenoma. Note diffuse osteopenia from hyperparathyroidism. Left paratracheal stripe Abnormal left paratracheal stripe
Widening of left paratracheal stripe with mass effect on the trachea due to large thyroid carcinoma and associated supraclavicular lymphadenopathy Posterior tracheal stripe Abnormal posterior tracheal stripe Widening of the posterior tracheal stripe due to dilated
esophagus in a patient with achalasia. Posterior wall of bronchus intermedius Abnormal posterior wall of bronchus intermedius Diffuse bandlike thickening of the posterior
wall of the bronchus intermedius in a patient with pulmonary oedema. Right paraspinal line Abnormal right paraspinal line Abnormal bulge in right paraspinal line inferiorly due to mediastinal hematoma from multiple right sided transverse
process fractures and an associated hemothorax. Left paraspinal line Abnormal left paraspinal line Focal lateral bulge in left paraspinal line due to extensive esophageal varices in patient with liver cirrhosis. Aortic-pulmonary stripe
Abnormal aortic-pulmonary stripe Abnormal contour of the aortic-pulmonary stripe due to lymphoma with anterior mediastinal lymphadenopathy within the prevascular space. Azygoesophageal recess
Abnormal azygoesophageal recess Abnormal contour and right lateral convexity of distal third of azygoesophageal recess due to a large hiatal hernia. Mediastinal spaces Four named spaces surrounding the central airways:
Pretracheal space Aortopulmonary window Subcarinal space Right paratracheal space Aortopulmonary window
Abnormal aortopulmonary window Abnormal bulge in AP window due to significant soft tissue mass within AP window and subcarinal space compatible with metastatic lymphadenopathy in a patient with bronchogenic carcinoma. Also widened right paratracheal stripe due to lymphadenopathy and left lower lobe consolidation.
Mediastinal lymphnodes American Thoracic Society definitions of regional lymph node stations
X Supraclavicular nodes 2R Right upper paratracheal nodes 2L Left upper paratracheal nodes
9 Right or left pulmonary ligament nodes 10R Right tracheobronchial nodes 10L Left tracheobroncheal nodes 11 Intrapulmonary nodes Conclusion Traditional frontal and lateral chest radiography remains a valuable tool in the evaluation of chest
disease despite increased reliance on CT, therefore familiarity with anatomic basis of mediastinal lines and stripes as seen on radiography imperative. Knowledge of normal anatomic structures within different mediastinal divisions helps guide formulation of appropriate differential diagnosis References Butler, P., Mitchell, A.W.M., Ellis, H. (1999). Applied
Radiological Anatomy. Cambridge: Cambridge University Press Ellis, H., Logan, B.M., Dixon, A.K. (2007). Human Sectional Anatomy Atlas of body sections, CT and MRI images, 3 rd ed. London: Hodder Arnold Gibbs, J.M., Chandrasekhar, C.A., Ferguson, E.C. et al. (2007). Lines and Stripes: Where did they go? From Conventional Radiography to CT. Radiographics, 27:33-48. Netter, F.H. (2011). Atlas of Human Anatomy, 5th ed. Philadelphia: Saunders Elsevier
Ryan, S., McNicholas, M., Eustace, S. (2011). Anatomy for diagnostic imaging, 3rd ed. London: Saunders Elsevier
Hypovolemic shock refers to a medical or surgical condition in which rapid fluid loss results in multiple organ failure due to inadequate circulating volume and subsequent inadequate perfusion. Loss of approximately one-fifth or more of the normal blood volume produces...
eAssignment System Improving feedback Dr Trevor Bryant 24th March 2011 * Handwritten * Produced in 2008, in their survey less than 1% receive feedback via Internet (online, email) - lack of recognition of feedback Written comments by 85% Marks grades...
Presentation Outline Common Cost Behavior Patterns Cost Estimation Methods The Relevant Range Cost-Volume Profit Analysis Degree of Operating Leverage Excel and Regression Analysis I. Common Cost Behavior Patterns Variable Costs Fixed Costs Discretionary versus Committed Fixed Costs Mixed Costs Step...
Who Buys China's Exports? For China, Dangerous Dependence on U.S. Market ... By final stage, nations within EU are entangled with "federal" law the same way U.S. states are. ... Note that this was on the ballot this past Tuesday....
Introduction to Animals What is an Animal? Animal Characteristics Cannot make their own food Digest their food (food has to be broken down in order for their bodies to use the proteins, fats, and carbohydrates Many move Multicellular Eukaryotic (have...
Location of pain, severity, exacerbating or alleviating factors, associated symptoms and radiation of pain. PMHx of conditions that may pre-dispose patient to cardiac etiology of chest pain. FamHx of early cardiac disease or deaths in family. Also of thrombotic diseases....
Situation de l'apprentissage en Alsace à la rentrée 2013 Effectif d'apprentis à la rentrée 2013 L'apprentissage en EPLE 5.735 apprentis dans 16 CFA (dont 2 ont chacun 2 UFA) + 213 apprentis en lycée (UFA rattachées à des CFA privés)...
Ready to download the document? Go ahead and hit continue!