[Radiological and anatomical analysis of the mediastinum after lobectomy]

To our knowledge, there have been few reports on radiological analysis of the mediastinum after lobectomy. The author reviewed 36 cases with pre and postoperative plain films and CT to evaluate anatomical changes of the mediastinum and causes of obliteration of mediastinal lines. The mediastinum was always shifted to the surgical side (2.7 cm) with rotation (10 degrees). The anterior junction line was thickened uniformly by proliferation of adipose tissue. On plain films, mediastinal lines were obliterated on the side of surgery. Contralateral side could be affected only in left lobectomy. The anatomical changes of mediastinum after lobectomy may be composed of following three factors; rotational shift, proliferation of adipose tissue, and secondary changes due to former two factors. The rotational shift and proliferation of adipose tissue have significant effects on anteriorly located mediastinal lines such as paratracheal line and the margin of the superior vena cava (SVC). The lines of the other side to the resected lobe could also be obliterated by these two factors.