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Mediastinal interfaces and lines in children: radiographic-CT correlation
1Department of Radiology, Sungkyunkwan University School of Medicine, Kangnam-gu, Seoul, South Korea.
Insights
Mediastinal interfaces and lines are visualized differently in children than adults on chest X-rays. CT correlation helps understand these differences and aids in interpreting pediatric radiographs.
Area of Science:
- Pediatric Radiology
- Thoracic Imaging
- Anatomical Variations
Background:
- Mediastinal interfaces and lines are well-established in adult radiography.
- Their understanding and visualization in pediatric patients remain less defined.
- This study addresses the knowledge gap in pediatric mediastinal anatomy on plain radiographs.
Purpose of the Study:
- To review mediastinal interfaces and lines on pediatric chest radiographs.
- To correlate findings with computed tomography (CT) scans.
- To assess the frequency and anatomical basis of these structures in children.
Main Methods:
- Retrospective review of 195 CT examinations and concurrent chest radiographs.
- Inclusion of 180 pediatric patients aged 1 month to 15 years.
- Assessment of visualization frequency and anatomical basis of key mediastinal structures.
Main Results:
- Visualization rates varied for different mediastinal interfaces and lines (e.g., SVC interface in 161, posterior junction line in 10).
- Non-visualization was attributed to anatomical differences or intrathoracic abnormalities.
- Visualization frequency correlated with age for several structures, with some increasing and others fluctuating.
Conclusions:
- Understanding the frequency and anatomical basis of pediatric mediastinal interfaces and lines is crucial.
- This knowledge aids in accurate interpretation of chest radiographs in children.
- CT correlation is valuable for clarifying visualization discrepancies.
Background:
Various mediastinal interfaces and lines are well known in adults, but not fully understood in children.
Objective:
To review the mediastinal interfaces and lines on plain radiographs in the paediatric age group with CT correlation.
Materials And Methods:
Soft copies of 195 sets of CT examinations and concurrent chest radiographs in 180 paediatric patients (age 1 month to 15 years) were retrospectively reviewed. The frequency of visualisation and the anatomical basis of the mediastinal interfaces and lines were assessed. The evaluated mediastinal interfaces and lines were superior vena cava interface, descending aorta interface, left paraspinal interface, azygoesophageal recess interface, right paratracheal stripe, anterior junction line and posterior junction line.
Results:
Chest radiographs showed the SVC interface in 161, the descending aorta interface in 155, the left paraspinal interface in 98, the azygoesophageal recess in 94, the right paratracheal stripe in 53, the anterior junction line in 15 and the posterior junction line in 10. Non-visualisation of mediastinal interfaces and lines on plain radiographs was explained by normal anatomical difference compared with the adult and underlying intrathoracic abnormalities when they were correlated with CT. The frequency of visualisation of the SVC interface, descending aortic interface, left paraspinal interface and azygoesophageal recess fluctuated with age, while the frequency of the right paratracheal stripe, anterior junction line and posterior junction line increased with age.
Conclusions:
Awareness of the frequency of visualisation and the anatomical basis of the mediastinal interfaces and lines in paediatric patients may be helpful for interpretation of chest radiographs.