[MDCT features and anatomic-pathology in right thoracic-abdominal junctional region diseases]

This paper was objected to determine the relationship between MDCT features and anatomic-pathology of diseases in right thoracic-abdominal junctional region. We cut 3 cadavers transversely and another 3 vertically to observe the anatomy of thoracic-abdominal junctional zone. We scanned 69 patients with diseases in right thoracic-abdominal junctional zone by MDCT. The correlation between MDCT features of right thoracic-abdominal junctional region and the anatomic-pathology in this region was evaluated. We found results as that in cadaver sections, the right pulmonary ligament, which was below inferior pulmonary vein, attached the inferior lobe of right lung to the esophagus, that the coronary ligament, which interiorly extended from falciform ligament and laterally formed into right triangular ligament, contained two layers, and that the bare area of liver, which positioned between the two layers of coronary ligament, was directly next to diaphragm with no peritoneum covered. There were 50 cases with both pleural and ascitic fluid, while the pleural fluid was divided into anterior and posterior compartments by the right pulmonary ligament, whereas the ascitic fluid was limited in perihepatic space in majority. Among the 50 cases, 5 patients had lung cancer with diaphragmatic pleura, diaphragm and upper abdomen involved. 5 patients had right hepatic lobe cancer with subdiaphragmatic peritoneum, crura diaphragmatis and lower thoracic cavity involved. 1 patient had right adrenal carcinoma with phrenic metastasis. 8 patients had inflammation in right lower thorax and/or right upper abdomen. The spreads of these diseases include mainly direct invasion, blood and lymphatic spread routs in the region. Conclusion could be drawn that the MDCT features and distribution of right thoracic-abdominal junctional region diseases correlate with the anatomical characteristics in this region.