X RAY CHEST IN EVALUATION OF MEDIASTINAL MASSES
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The document discusses several anatomical lines in the mediastinum that divide it theoretically rather than physically. It describes the locations and normal appearances of the anterior junction line, posterior junction line, azygoesophageal line, para-aortic line, and paraspinal lines. Key points include that the anterior junction line is always concave towards the lung, while the posterior junction line extends above the sternoclavicular notch. The azygoesophageal line forms an inverted S curve behind the esophagus. The document also notes how locations of masses and abnormalities can be identified relative to these anatomical lines and structures.
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4. The right paratracheal line outlines the right side of the trachea and may indicate adjacent disease when thickened.
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From Dr Ng Kian Seng:"Please send this out to all those coming, it is just a revision of the fundamentals. I dont intend to go through this at the workshop.
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X RAY CHEST IN EVALUATION OF MEDIASTINAL MASSES
- 2. In any method used to divide the mediastinum, the divisions are theoretic rather than physical. Therefore, disease can spread from one compartment to another, and some diseases do not occur exclusively in any one compartment.
- 6. Anterior junction line (AJL) formed by the anterior apposition of the two lungs together with their respective pleuralcoverings and a thin layer of mediastinal tissue
- 8. ALWAYS CONCAVE OR FLAT TOWARDS THE LUNG CONVEX = ABNORMAL
- 10. It is formed by the contact of the posterior aspects of the left and right lungs behind the esophagus creating a sagittal pleural interface Contrary to the anterior junction line, it extends cranially above the sternoclavicular notch.
- 12. NORMAL THICKNESS 1-4 MM > 5MM IS ABNORMAL
- 14. Azygoesophageal Line , Situated behind the heart and the mediastinum and formed by the interface between the air-filled right lower lobe and the posterior mediastinal tissue laterally from the mid and lower third of the esophagus It describes an “inverted S” curve and joins the azygos arch and the right Paratracheal lines above the azygoesophageal recess
- 16. The para-aortic line follows the Descending aorta on the left side. It is formed by the interface with the aerated lower left lobe.
- 18. Paraspinal lines are formed on both sides by the tangential contact of the lungs and the pleura with the posterior Paravertebral soft tissues
- 19. WHERE IS THE MASS LOCATED AND WHY?
- 20. HILUM OVERLAY SIGN POSITIVE DESCENDING AORTA NOT OBSCURED MASS IS IN ANTERIOR MED
- 23. PERICARDIAL CYST 70% ARE LOCATED AT RIGHT CARDIOPHRENIC ANGLE WELL DEFINED WALL MAY BE CALCIFIED
- 24. MORGAGNIAN HERNIA AIR WITHIN THE BOWEL LOOPS HELPS IN DIFFERENTIATING