[Computerized tomography imaging of the anterior cardiophrenic angle]

The anterior cardiophrenic angle (ACA) is the lowermost anterolateral portion of the mediastinum. It is limited inferiorly by the diaphragm, anteriorly by the chest wall, posteriorly by the pericardium, and laterally by the parietal pleura. In 20% computed tomography (CT) of the normal ACA shows the diaphragm as a linear structure, and in 15% as a pseudotumorous structure that has to be differentiated from real tumours. The inferior sternopericardial ligament appears as a linear structure in 22%. In 3% nodular structures of up to 8 mm of diameter are visible in the normal ACA, probably corresponding to cardiophrenic angle nodes. These findings suggest that, exceptionally, normal cardiophrenic angle nodes may be demonstrated by CT.