The right paratracheal stripe in blunt chest trauma

Supine chest radiographs and thoracic arteriograms were obtained in 102 consecutive patients with blunt chest trauma. The initial chest radiographs were reviewed retrospectively without knowledge of the arteriographic findings, and measurements of the right paratracheal stripe were obtained. All patients with right paratracheal stripes less than 5 mm in width had normal arteriograms. In those patients in whom the right paratracheal stripe measured 5 mm or greater, arteriography revealed major arterial injury in 22.9% of cases. It is concluded that measurement of the right paratracheal stripe on supine 102-cm radiographs provides a reliable and quantitative indicator of mediastinal hemorrhage, allowing early arteriographic evaluation.