A safe area for sternal puncture in children: an MSCT study based on sternal development

Area of Science:

• Pediatric Radiology
• Anatomical Imaging
• Thoracic Anatomy

Background:

• Sternal puncture is a diagnostic procedure in children.
• Understanding sternal development is crucial for safe and effective sternal puncture.
• Multislice spiral CT (MSCT) offers detailed anatomical visualization.

Purpose of the Study:

• To investigate the anatomical characteristics of sternal development in children using MSCT.
• To establish an anatomical basis for performing sternal puncture in pediatric patients.
• To correlate sternal ossification patterns with age and adjacent structures.

Main Methods:

• Retrospective analysis of thoracic MSCT data from 600 children (1 month to 19 years).
• Observation of sternal ossification centers and adjacent tissues.
• Measurement of subcutaneous soft tissue thickness and skin-to-sternum distance.
• Linear correlation analysis between measurements and age.

Main Results:

• Sternal manubrium and mesosternum segments I and II ossification were present in all cases.
• Nonossification was observed in segments III, IV, and the xiphoid process, often adjacent to pericardial and lung tissue.
• Subcutaneous soft tissue thickness and skin-to-sternum distance positively correlated with age.
• Skin-to-sternum distance strongly correlated with subcutaneous soft tissue thickness.

Conclusions:

• Sternal ossification typically completes by segment II; nonossification below this is common and adjacent to vital organs.
• Pediatric sternal puncture is recommended at the sternal manubrium and mesosternum segments I and II.
• Careful consideration of ossification patterns and subcutaneous tissue depth is essential for safe sternal puncture.