Glomerular Filtration and determinants of glomerular filtration .pptx
Lines & mediastinal stripes 02
1. Dr Mazen Qusaibaty
MD, DIS
Head Pulmonary and Internist Department
Ibnalnafisse Hospital
Ministry of Syrian health
Email: Qusaibaty@gmail.com
Lines & mediastinal Stripes - 02
2. Topic Outline
2
1. Anterior junction line complex
2. Aortic-Pulmonary Stripe
3. Right Paraspinal Line
4. Posterior Tracheal Stripe
(Tracheoesophageal Stripe)
5. Azygoesophageal Recess
14. Aortic-Pulmonary Stripe
(A mediastinal interface )
Formed
The pleura
of the
anterior
left lung
The mediastinal fat of
anterolateral to
The left
pulmonary
artery
Aortic arch
14
15. Aortic-Pulmonary Stripe
• The stripe is straight or mildly convex, crossing
laterally over the aortic arch and the main
pulmonary artery
15
22. Chest radiograph with superimposed
mediastinal stripes
Light blue
Right paraspinal
stripe
22
23. Right and left paraspinal stripes
(A mediastinal interface )
• It represents an
interface between
the right lung and
the posterior
mediastinal fat and
soft tissues.
23
24. Right paraspinal stripes
• The right paraspinal line appears straight and
typically extends from T8 – T1224
36. Left paraspinal stripe
36
• The left paraspinal line is seen more frequently than
the right paraspinal line due to the presence of the
descending thoracic aorta on the left
37. An abnormal contour of the left paraspinal line
Tortuosity Of
The Descending
Thoracic Aorta
Osteophytes
A Mediastinal
Fat
37
38. An abnormal contour of the left paraspinal line
A Mediastinal
Hematoma
Extramedullary
Hematopoiesis
Esophageal
Varices
38
39. An abnormal contour of the left paraspinal line
39
• CT scan shows
extensive
esophageal varices
(arrow), which are
responsible for the
abnormal contour of
the left paraspinal
line.
41. The posterior tracheal stripe
41
FranquetT, Erasmus JJ, Gimenez A, Rossi S, Pratts R. The retrotracheal space: normal
anatomic and pathologic appearances.RadioGraphics2002; 22(spec no): S231–S246.
• Is a vertical stripe seen on lateral chest
radiographs
42. The posterior tracheal stripe
• That is formed by air
within the trachea
and right lung
outlining the
posterior tracheal
wall and intervening
soft tissues
42
FranquetT, Erasmus JJ, Gimenez A, Rossi S, Pratts R. The retrotracheal space: normal
anatomic and pathologic appearances.RadioGraphics2002; 22(spec no): S231–S246.
43. The posterior tracheal stripe
• It typically measures
up to 2.5 mm in
thickness
43
ProtoAV, Speckman JM. The left lateral radiograph of the chest. I.Med Radiogr
Photogr1979; 55: 29–74.
88. Why should we distinguish the posterior
tracheal stripe & Retro-tracheal triangle ?
• Franquet et al
observed that the
most common
abnormalities within
the retrotracheal
space are congenital
developmental
anomalies of the
aortic arch
90 FranquetT, Erasmus JJ, Gimenez A, Rossi S, Pratts R. The retrotracheal space: normal anatomic and pathologic
appearances.RadioGraphics2002; 22(spec no): S231–S246.
89. Abnormal thickening
of the posterior
tracheal stripe
Acquired vascular
lesions
Esophageal lesions
Lymphatic
malformations
Mediastinitis
Post-traumatic
hematomas
91
101. Abnormal contour of Azygoesophageal recess
• The distal third of
the azygoesophageal
recess demonstrates
an abnormal contour
and right lateral
convexity (arrows)
103
A Diagnostic Approach
to Mediastinal Abnormalities
Camilla R. Whitten, MRCS, FRCR ● Sameer Khan, MRCP, FRCR
Graham J. Munneke, MRCP, FRCR ● Sisa Grubnic, MRCP, FRCR
http://radiographics.rsna.org/content/27/3/657.full?sid=b4229644-a916-4d4a-9f5a-1c4ca09125df#F1
Chest radiograph with superimposed mediastinal stripes. Yellow: right paratracheal stripe. Light blue: right and left paraspinal stripes. Red: azygoesophageal stripe. Brown: pleuroesophageal stripe. Purple: anterior junction line complex. Pink: left subclavian artery border. Light green: posterior-superior junction line. Dark green: para-aortic line.
Anterior junction line on PA chest radiograph (arrows).
Note that the line does not extend above the level of the c lavic les.
Abnormal-appearing anterior junction line in a patient who had undergone a right middle lobectomy. (a) Frontal chest radiograph shows the anterior junction line (arrows) displaced to the right. Note also the volume loss in the right lung as demonstrated by elevation of the right hemidiaphragm.
Abnormal-appearing anterior junction line in a patient who had undergone a right middle lobectomy. (a) Frontal chest radiograph shows the anterior junction line (arrows) displaced to the right. Note also the volume loss in the right lung as demonstrated by elevation of the right hemidiaphragm.
Abnormal-appearing anterior junction line in a patient who had undergone a right middle lobectomy. (a) Frontal chest radiograph shows the anterior junction line (arrows) displaced to the right. Note also the volume loss in the right lung as demonstrated by elevation of the right hemidiaphragm.
Abnormal-appearing anterior junction line in a patient who had undergone a right middle lobectomy. (a) Frontal chest radiograph shows the anterior junction line (arrows) displaced to the right. Note also the volume loss in the right lung as demonstrated by elevation of the right hemidiaphragm.
Anterior and Posterior Junction Lines. A. A posteroanterior chest film shows both anterior (solid arrows) and posterior (open arrows) junction lines. B. CT through the upper thorax in another patient shows the anterior junction line in the retrosternal space, while the posterior junction line lies in the retrotracheal space.
First described by Keats (7), the aortic-pulmo-nary stripe actually represents a mediastinal reflection or interface formed by the pleura of the anterior left lung coming in contact with and tangentially reflecting over the mediastinal fat anterolateral to the left pulmonary artery and aortic arch. The stripe is straight or mildly convex, crossing laterally over the aortic arch and the main pulmonary artery
First described by Keats (7), the aortic-pulmo-nary stripe actually represents a mediastinal reflection or interface formed by the pleura of the anterior left lung coming in contact with and tangentially reflecting over the mediastinal fat anterolateral to the left pulmonary artery and aortic arch. The stripe is straight or mildly convex, crossing laterally over the aortic arch and the main pulmonary artery
CT scan shows a normal aortic-pulmonary
stripe (arrows) formed by the anterior left lung contacting
and tangentially reflecting over the mediastinal fat anterolateral
to the left pulmonary artery and aortic arch.
Abnormal-appearing aortic-pulmonary stripe in a 42-year-old patient with lymphoma. (a) Frontal chest
radiograph demonstrates abnormal contour of the aortic-pulmonary stripe (arrows). (b) CT scan shows anterior mediastinal
lymphadenopathy (arrows) within the prevascular space.
Abnormal-appearing aortic-pulmonary stripe in a 42-year-old patient with lymphoma. (a) Frontal chest
radiograph demonstrates abnormal contour of the aortic-pulmonary stripe (arrows). (b) CT scan shows anterior mediastinal
lymphadenopathy (arrows) within the prevascular space.
Abnormal-appearing aortic-pulmonary stripe in a 42-year-old patient with lymphoma. (a) Frontal chest
radiograph demonstrates abnormal contour of the aortic-pulmonary stripe (arrows). (b) CT scan shows anterior mediastinal
lymphadenopathy (arrows) within the prevascular space.
Keats’ original study described elevation of the
aortic-pulmonary stripe in two patients with
pneumomediastinum (7). Anterior mediastinal
disease such as thyroid or thymic masses or prevascular
lymphadenopathy (Fig 13) may alter
the normal appearance of the stripe, causing increased
convexity laterally (8).
Chest radiograph with superimposed mediastinal stripes. Yellow: right paratracheal stripe. Light blue: right and left paraspinal stripes. Red: azygoesophageal stripe. Brown: pleuroesophageal stripe. Purple: anterior junction line complex. Pink: left subclavian artery border. Light green: posterior-superior junction line. Dark green: para-aortic line.
The right paraspinal line appears straight and typically extends from the 8th through the 12th thoracic vertebral levels
CT scan shows normal right and left paraspinal lines (arrows) formed by the lungs and pleura contacting the posterior mediastinal soft tissues.
Abnormal-appearing right paraspinal line in a 27-year-old patient who had sustained traumatic injury.
CT scan reveals a large mediastinal hematoma (arrow) from multiple right-sided transverse process fractures of the thoracic spine and an associated right hemothorax.
CT scan reveals a large mediastinal hematoma (arrow) from multiple right-sided transverse process fractures of the thoracic spine and an associated right hemothorax.
The left paraspinal line is formed by tangential contact of the left lung and pleura with the posterior mediastinal fat, left paraspinal muscles, and adjacent soft tissues. The left paraspinal line extends vertically from the aortic arch to the diaphragm and typically lies medial to the lateral wall of the descending thoracic aorta (Figs 18, 20) (1). In some instances, however, it may lie lateral to the aorta along the lower intrathoracic course of the aorta.
The left paraspinal line is formed by tangential contact of the left lung and pleura with the posterior mediastinal fat, left paraspinal muscles, and adjacent soft tissues. The left paraspinal line extends vertically from the aortic arch to the diaphragm and typically lies medial to the lateral wall of the descending thoracic aorta (Figs 18, 20) (1). In some instances, however, it may lie lateral to the aorta along the lower intrathoracic course of the aorta.
The left paraspinal line is formed by tangential contact of the left lung and pleura with the posterior mediastinal fat, left paraspinal muscles, and adjacent soft tissues. The left paraspinal line extends vertically from the aortic arch to the diaphragm and typically lies medial to the lateral wall of the descending thoracic aorta (Figs 18, 20) (1). In some instances, however, it may lie lateral to the aorta along the lower intrathoracic course of the aorta.
The left paraspinal line is formed by tangential contact of the left lung and pleura with the posterior mediastinal fat, left paraspinal muscles, and adjacent soft tissues. The left paraspinal line extends vertically from the aortic arch to the diaphragm and typically lies medial to the lateral wall of the descending thoracic aorta (Figs 18, 20) (1). In some instances, however, it may lie lateral to the aorta along the lower intrathoracic course of the aorta.
Reported on 41% of posteroanterior radiographs, the left paraspinal line is seen more frequently than the right paraspinal line due to the presence of the descending thoracic aorta on the left, which promotes the tangential contact of the left lung necessary to produce the lung-mediastinum interface
Reported on 41% of posteroanterior radiographs, the left paraspinal line is seen more frequently than the right paraspinal line due to the presence of the descending thoracic aorta on the left, which promotes the tangential contact of the left lung necessary to produce the lung-mediastinum interface
As with the right paraspinal line, osteophytes or prominent mediastinal fat can cause an abnormal contour of the left paraspinal line; however, tortuosity of the descending thoracic aorta may also displace it. Abnormal contour or displacement may also suggest additional posterior mediastinal abnormalities such as a mediastinal hematoma, a mass, extramedullary hematopoiesis, or esophageal varices
As with the right paraspinal line, osteophytes or prominent mediastinal fat can cause an abnormal contour of the left paraspinal line; however, tortuosity of the descending thoracic aorta may also displace it. Abnormal contour or displacement may also suggest additional posterior mediastinal abnormalities such as a mediastinal hematoma, a mass, extramedullary hematopoiesis, or esophageal varices
As with the right paraspinal line, osteophytes or prominent mediastinal fat can cause an abnormal contour of the left paraspinal line; however, tortuosity of the descending thoracic aorta may also displace it. Abnormal contour or displacement may also suggest additional posterior mediastinal abnormalities such as a mediastinal hematoma, a mass, extramedullary hematopoiesis, or esophageal varices
The posterior tracheal stripe is a vertical stripe seen on lateral chest radiographs that is formed by air within the trachea and right lung outlining the posterior tracheal wall and intervening soft tissues (Figs 22, 23) (10,11). It typically measures up to 2.5 mm in thickness. When the posterior trachea comes in contact with the anterior wall of the esophagus, however, the esophageal wall, the posterior tracheal wall, and intervening soft tissues combine to form a thicker tracheoesophageal stripe, which may measure up to 5.5 mm
The posterior tracheal stripe is a vertical stripe seen on lateral chest radiographs that is formed by air within the trachea and right lung outlining the posterior tracheal wall and intervening soft tissues (Figs 22, 23) (10,11). It typically measures up to 2.5 mm in thickness. When the posterior trachea comes in contact with the anterior wall of the esophagus, however, the esophageal wall, the posterior tracheal wall, and intervening soft tissues combine to form a thicker tracheoesophageal stripe, which may measure up to 5.5 mm
The posterior tracheal stripe is a vertical stripe seen on lateral chest radiographs that is formed by air within the trachea and right lung outlining the posterior tracheal wall and intervening soft tissues It typically measures up to 2.5 mm in thickness. When the posterior trachea comes in contact with the anterior wall of the esophagus, however, the esophageal wall, the posterior tracheal wall, and intervening soft tissues combine to form a thicker tracheoesophageal stripe, which may measure up to 5.5 mm
FranquetT, Erasmus JJ, Gimenez A, Rossi S, Pratts R. The retrotracheal space: normal anatomic and pathologic appearances.RadioGraphics2002; 22(spec no): S231–S246.
The posterior tracheal stripe is a vertical stripe seen on lateral chest radiographs that is formed by air within the trachea and right lung outlining the posterior tracheal wall and intervening soft tissues It typically measures up to 2.5 mm in thickness. When the posterior trachea comes in contact with the anterior wall of the esophagus, however, the esophageal wall, the posterior tracheal wall, and intervening soft tissues combine to form a thicker tracheoesophageal stripe, which may measure up to 5.5 mm
FranquetT, Erasmus JJ, Gimenez A, Rossi S, Pratts R. The retrotracheal space: normal anatomic and pathologic appearances.RadioGraphics2002; 22(spec no): S231–S246.
CT scan reveals that the posterior tracheal stripe (arrow) is formed by air within the trachea and right lung outlining the posterior tracheal wall and intervening soft tissues
A: PA view showingt trachea (1), right mainstem
bronchus (2), left mainstem bronchus (3), aort ic “knob” or arch (4), azygos
vein empt ying into superior vena cava (5), right interlobar pulmonary artery
(6), left pulmonary artery (7), right upper lobe pulmonary artery (t runc us
anterior) (8), right inferior pulmonary vein (9), right at rium (10), left vent ric le
(11), and other st ruc tures as labeled.
A: PA view showingt trachea (1), right mainstem
bronchus (2), left mainstem bronchus (3), aort ic “knob” or arch (4), azygos
vein empt ying into superior vena cava (5), right interlobar pulmonary artery
(6), left pulmonary artery (7), right upper lobe pulmonary artery (t runc us
anterior) (8), right inferior pulmonary vein (9), right at rium (10), left vent ric le
(11), and other st ruc tures as labeled.
A: PA view showingt trachea (1), right mainstem
bronchus (2), left mainstem bronchus (3), aort ic “knob” or arch (4), azygos
vein empt ying into superior vena cava (5), right interlobar pulmonary artery
(6), left pulmonary artery (7), right upper lobe pulmonary artery (t runc us
anterior) (8), right inferior pulmonary vein (9), right at rium (10), left vent ric le
(11), and other st ruc tures as labeled.
A: PA view showingt trachea (1), right mainstem
bronchus (2), left mainstem bronchus (3), aort ic “knob” or arch (4), azygos
vein empt ying into superior vena cava (5), right interlobar pulmonary artery
(6), left pulmonary artery (7), right upper lobe pulmonary artery (t runc us
anterior) (8), right inferior pulmonary vein (9), right at rium (10), left vent ric le
(11), and other st ruc tures as labeled.
A: PA view showingt trachea (1), right mainstem
bronchus (2), left mainstem bronchus (3), aort ic “knob” or arch (4), azygos
vein empt ying into superior vena cava (5), right interlobar pulmonary artery
(6), left pulmonary artery (7), right upper lobe pulmonary artery (t runc us
anterior) (8), right inferior pulmonary vein (9), right at rium (10), left vent ric le
(11), and other st ruc tures as labeled.
A: PA view showingt trachea (1), right mainstem
bronchus (2), left mainstem bronchus (3), aort ic “knob” or arch (4), azygos
vein empt ying into superior vena cava (5), right interlobar pulmonary artery
(6), left pulmonary artery (7), right upper lobe pulmonary artery (t runc us
anterior) (8), right inferior pulmonary vein (9), right at rium (10), left vent ric le
(11), and other st ruc tures as labeled.
A: PA view showingt trachea (1), right mainstem
bronchus (2), left mainstem bronchus (3), aort ic “knob” or arch (4), azygos
vein empt ying into superior vena cava (5), right interlobar pulmonary artery
(6), left pulmonary artery (7), right upper lobe pulmonary artery (t runc us
anterior) (8), right inferior pulmonary vein (9), right at rium (10), left vent ric le
(11), and other st ruc tures as labeled.
A: PA view showingt trachea (1), right mainstem
bronchus (2), left mainstem bronchus (3), aort ic “knob” or arch (4), azygos
vein empt ying into superior vena cava (5), right interlobar pulmonary artery
(6), left pulmonary artery (7), right upper lobe pulmonary artery (t runc us
anterior) (8), right inferior pulmonary vein (9), right at rium (10), left vent ric le
(11), and other st ruc tures as labeled.
A: PA view showingt trachea (1), right mainstem
bronchus (2), left mainstem bronchus (3), aort ic “knob” or arch (4), azygos
vein empt ying into superior vena cava (5), right interlobar pulmonary artery
(6), left pulmonary artery (7), right upper lobe pulmonary artery (t runc us
anterior) (8), right inferior pulmonary vein (9), right at rium (10), left vent ric le
(11), and other st ruc tures as labeled.
A: PA view showingt trachea (1), right mainstem
bronchus (2), left mainstem bronchus (3), aort ic “knob” or arch (4), azygos
vein empt ying into superior vena cava (5), right interlobar pulmonary artery
(6), left pulmonary artery (7), right upper lobe pulmonary artery (t runc us
anterior) (8), right inferior pulmonary vein (9), right at rium (10), left vent ric le
(11), and other st ruc tures as labeled.
A: PA view showingt trachea (1), right mainstem
bronchus (2), left mainstem bronchus (3), aort ic “knob” or arch (4), azygos
vein empt ying into superior vena cava (5), right interlobar pulmonary artery
(6), left pulmonary artery (7), right upper lobe pulmonary artery (t runc us
anterior) (8), right inferior pulmonary vein (9), right at rium (10), left vent ric le
(11), and other st ruc tures as labeled.
A: PA view showingt trachea (1), right mainstem
bronchus (2), left mainstem bronchus (3), aort ic “knob” or arch (4), azygos
vein empt ying into superior vena cava (5), right interlobar pulmonary artery
(6), left pulmonary artery (7), right upper lobe pulmonary artery (t runc us
anterior) (8), right inferior pulmonary vein (9), right at rium (10), left vent ric le
(11), and other st ruc tures as labeled.
A: PA view showingt trachea (1), right mainstem
bronchus (2), left mainstem bronchus (3), aort ic “knob” or arch (4), azygos
vein empt ying into superior vena cava (5), right interlobar pulmonary artery
(6), left pulmonary artery (7), right upper lobe pulmonary artery (t runc us
anterior) (8), right inferior pulmonary vein (9), right at rium (10), left vent ric le
(11), and other st ruc tures as labeled.
A: PA view showingt trachea (1), right mainstem
bronchus (2), left mainstem bronchus (3), aort ic “knob” or arch (4), azygos
vein empt ying into superior vena cava (5), right interlobar pulmonary artery
(6), left pulmonary artery (7), right upper lobe pulmonary artery (t runc us
anterior) (8), right inferior pulmonary vein (9), right at rium (10), left vent ric le
(11), and other st ruc tures as labeled.
A: PA view showingt trachea (1), right mainstem
bronchus (2), left mainstem bronchus (3), aort ic “knob” or arch (4), azygos
vein empt ying into superior vena cava (5), right interlobar pulmonary artery
(6), left pulmonary artery (7), right upper lobe pulmonary artery (t runc us
anterior) (8), right inferior pulmonary vein (9), right at rium (10), left vent ric le
(11), and other st ruc tures as labeled.
A: PA view showingt trachea (1), right mainstem
bronchus (2), left mainstem bronchus (3), aort ic “knob” or arch (4), azygos
vein empt ying into superior vena cava (5), right interlobar pulmonary artery
(6), left pulmonary artery (7), right upper lobe pulmonary artery (t runc us
anterior) (8), right inferior pulmonary vein (9), right at rium (10), left vent ric le
(11), and other st ruc tures as labeled.
A: PA view showingt trachea (1), right mainstem
bronchus (2), left mainstem bronchus (3), aort ic “knob” or arch (4), azygos
vein empt ying into superior vena cava (5), right interlobar pulmonary artery
(6), left pulmonary artery (7), right upper lobe pulmonary artery (t runc us
anterior) (8), right inferior pulmonary vein (9), right at rium (10), left vent ric le
(11), and other st ruc tures as labeled.
A: PA view showingt trachea (1), right mainstem
bronchus (2), left mainstem bronchus (3), aort ic “knob” or arch (4), azygos
vein empt ying into superior vena cava (5), right interlobar pulmonary artery
(6), left pulmonary artery (7), right upper lobe pulmonary artery (t runc us
anterior) (8), right inferior pulmonary vein (9), right at rium (10), left vent ric le
(11), and other st ruc tures as labeled.
A: PA view showingt trachea (1), right mainstem
bronchus (2), left mainstem bronchus (3), aort ic “knob” or arch (4), azygos
vein empt ying into superior vena cava (5), right interlobar pulmonary artery
(6), left pulmonary artery (7), right upper lobe pulmonary artery (t runc us
anterior) (8), right inferior pulmonary vein (9), right at rium (10), left vent ric le
(11), and other st ruc tures as labeled.
A: PA view showingt trachea (1), right mainstem
bronchus (2), left mainstem bronchus (3), aort ic “knob” or arch (4), azygos
vein empt ying into superior vena cava (5), right interlobar pulmonary artery
(6), left pulmonary artery (7), right upper lobe pulmonary artery (t runc us
anterior) (8), right inferior pulmonary vein (9), right at rium (10), left vent ric le
(11), and other st ruc tures as labeled.
A: PA view showingt trachea (1), right mainstem
bronchus (2), left mainstem bronchus (3), aort ic “knob” or arch (4), azygos
vein empt ying into superior vena cava (5), right interlobar pulmonary artery
(6), left pulmonary artery (7), right upper lobe pulmonary artery (t runc us
anterior) (8), right inferior pulmonary vein (9), right at rium (10), left vent ric le
(11), and other st ruc tures as labeled.
A: PA view showingt trachea (1), right mainstem
bronchus (2), left mainstem bronchus (3), aort ic “knob” or arch (4), azygos
vein empt ying into superior vena cava (5), right interlobar pulmonary artery
(6), left pulmonary artery (7), right upper lobe pulmonary artery (t runc us
anterior) (8), right inferior pulmonary vein (9), right at rium (10), left vent ric le
(11), and other st ruc tures as labeled.
Lateral view showing pulmonary
out flow t rac t (1), ascending aorta (2), aort ic arch (3), brac hioc ephalic
vessels (4), t rachea (5), right upper lobe bronchus (6), left upper lobe
bronchus (7), right pulmonary artery (8), left pulmonary artery (9),
c onfluenc e of pulmonary veins (10), and other st ruc tures as labeled.
Lateral view showing pulmonary
out flow t rac t (1), ascending aorta (2), aort ic arch (3), brac hioc ephalic
vessels (4), t rachea (5), right upper lobe bronchus (6), left upper lobe
bronchus (7), right pulmonary artery (8), left pulmonary artery (9),
c onfluenc e of pulmonary veins (10), and other st ruc tures as labeled.
Lateral view showing pulmonary
out flow t rac t (1), ascending aorta (2), aort ic arch (3), brac hioc ephalic
vessels (4), t rachea (5), right upper lobe bronchus (6), left upper lobe
bronchus (7), right pulmonary artery (8), left pulmonary artery (9),
c onfluenc e of pulmonary veins (10), and other st ruc tures as labeled.
Lateral view showing pulmonary
out flow t rac t (1), ascending aorta (2), aort ic arch (3), brac hioc ephalic
vessels (4), t rachea (5), right upper lobe bronchus (6), left upper lobe
bronchus (7), right pulmonary artery (8), left pulmonary artery (9),
c onfluenc e of pulmonary veins (10), and other st ruc tures as labeled.
Lateral view showing pulmonary
out flow t rac t (1), ascending aorta (2), aort ic arch (3), brac hioc ephalic
vessels (4), t rachea (5), right upper lobe bronchus (6), left upper lobe
bronchus (7), right pulmonary artery (8), left pulmonary artery (9),
c onfluenc e of pulmonary veins (10), and other st ruc tures as labeled.
Lateral view showing pulmonary
out flow t rac t (1), ascending aorta (2), aort ic arch (3), brac hioc ephalic
vessels (4), t rachea (5), right upper lobe bronchus (6), left upper lobe
bronchus (7), right pulmonary artery (8), left pulmonary artery (9),
c onfluenc e of pulmonary veins (10), and other st ruc tures as labeled.
Lateral view showing pulmonary
out flow t rac t (1), ascending aorta (2), aort ic arch (3), brac hioc ephalic
vessels (4), t rachea (5), right upper lobe bronchus (6), left upper lobe
bronchus (7), right pulmonary artery (8), left pulmonary artery (9),
c onfluenc e of pulmonary veins (10), and other st ruc tures as labeled.
Lateral view showing pulmonary
out flow t rac t (1), ascending aorta (2), aort ic arch (3), brac hioc ephalic
vessels (4), t rachea (5), right upper lobe bronchus (6), left upper lobe
bronchus (7), right pulmonary artery (8), left pulmonary artery (9),
c onfluenc e of pulmonary veins (10), and other st ruc tures as labeled.
Lateral view showing pulmonary
out flow t rac t (1), ascending aorta (2), aort ic arch (3), brac hioc ephalic
vessels (4), t rachea (5), right upper lobe bronchus (6), left upper lobe
bronchus (7), right pulmonary artery (8), left pulmonary artery (9),
c onfluenc e of pulmonary veins (10), and other st ruc tures as labeled.
Lateral view showing pulmonary
out flow t rac t (1), ascending aorta (2), aort ic arch (3), brac hioc ephalic
vessels (4), t rachea (5), right upper lobe bronchus (6), left upper lobe
bronchus (7), right pulmonary artery (8), left pulmonary artery (9),
c onfluenc e of pulmonary veins (10), and other st ruc tures as labeled.
Lateral view showing pulmonary
out flow t rac t (1), ascending aorta (2), aort ic arch (3), brac hioc ephalic
vessels (4), t rachea (5), right upper lobe bronchus (6), left upper lobe
bronchus (7), right pulmonary artery (8), left pulmonary artery (9),
c onfluenc e of pulmonary veins (10), and other st ruc tures as labeled.
Lateral view showing pulmonary
out flow t rac t (1), ascending aorta (2), aort ic arch (3), brac hioc ephalic
vessels (4), t rachea (5), right upper lobe bronchus (6), left upper lobe
bronchus (7), right pulmonary artery (8), left pulmonary artery (9),
c onfluenc e of pulmonary veins (10), and other st ruc tures as labeled.
Lateral view showing pulmonary
out flow t rac t (1), ascending aorta (2), aort ic arch (3), brac hioc ephalic
vessels (4), t rachea (5), right upper lobe bronchus (6), left upper lobe
bronchus (7), right pulmonary artery (8), left pulmonary artery (9),
c onfluenc e of pulmonary veins (10), and other st ruc tures as labeled.
Lateral view showing pulmonary
out flow t rac t (1), ascending aorta (2), aort ic arch (3), brac hioc ephalic
vessels (4), t rachea (5), right upper lobe bronchus (6), left upper lobe
bronchus (7), right pulmonary artery (8), left pulmonary artery (9),
c onfluenc e of pulmonary veins (10), and other st ruc tures as labeled.
Lateral view showing pulmonary
out flow t rac t (1), ascending aorta (2), aort ic arch (3), brac hioc ephalic
vessels (4), t rachea (5), right upper lobe bronchus (6), left upper lobe
bronchus (7), right pulmonary artery (8), left pulmonary artery (9),
c onfluenc e of pulmonary veins (10), and other st ruc tures as labeled.
Lateral view showing pulmonary
out flow t rac t (1), ascending aorta (2), aort ic arch (3), brac hioc ephalic
vessels (4), t rachea (5), right upper lobe bronchus (6), left upper lobe
bronchus (7), right pulmonary artery (8), left pulmonary artery (9),
c onfluenc e of pulmonary veins (10), and other st ruc tures as labeled.
Lateral view showing pulmonary
out flow t rac t (1), ascending aorta (2), aort ic arch (3), brac hioc ephalic
vessels (4), t rachea (5), right upper lobe bronchus (6), left upper lobe
bronchus (7), right pulmonary artery (8), left pulmonary artery (9),
c onfluenc e of pulmonary veins (10), and other st ruc tures as labeled.
Lateral view showing pulmonary
out flow t rac t (1), ascending aorta (2), aort ic arch (3), brac hioc ephalic
vessels (4), t rachea (5), right upper lobe bronchus (6), left upper lobe
bronchus (7), right pulmonary artery (8), left pulmonary artery (9),
c onfluenc e of pulmonary veins (10), and other st ruc tures as labeled.
Lateral view showing pulmonary
out flow t rac t (1), ascending aorta (2), aort ic arch (3), brac hioc ephalic
vessels (4), t rachea (5), right upper lobe bronchus (6), left upper lobe
bronchus (7), right pulmonary artery (8), left pulmonary artery (9),
c onfluenc e of pulmonary veins (10), and other st ruc tures as labeled.
Lateral view showing pulmonary
out flow t rac t (1), ascending aorta (2), aort ic arch (3), brac hioc ephalic
vessels (4), t rachea (5), right upper lobe bronchus (6), left upper lobe
bronchus (7), right pulmonary artery (8), left pulmonary artery (9),
c onfluenc e of pulmonary veins (10), and other st ruc tures as labeled.
The posterior tracheal stripe forms the anterior border of the retrotracheal space (Raider or retro-tracheal triangle), with the remaining borders being the spine posteriorly, the aortic arch inferiorly, and the thoracic inlet superiorly
The posterior tracheal stripe forms the anterior border of the retrotracheal space (Raider or retro-tracheal triangle), with the remaining borders being the spine posteriorly, the aortic arch inferiorly, and the thoracic inlet superiorly
Franquet et al observed that the most common abnormalities within the retrotracheal space are congenital developmental anomalies of the aortic arch.
Acquired vascular lesions, esophageal lesions, lymphatic malformations, mediastinitis, and post-traumatic hematomas may also cause abnormal thickening of the posterior tracheal stripe
CT scan demonstrates a dilated esophagus (arrow) filled with food and contrast material.
Abnormal posterior tracheal stripe in a 49-year-old patient with achalasia
Abnormal posterior tracheal stripe in a 49-year-old patient with achalasia
Although not considered a mediastinal line or stripe, the azygoesophageal recess remains an important mediastinal interface caused by differences in density between the mediastinum and the posteromedial portion of the right lower lobe. The azygoesophageal recess represents a space lying lateral or posterior to the esophagus and anterior to the spine, extending from the level of the anterior turn of the azygos vein to the level of the aortic hiatus inferiorly.The right infraazygos pleuroesophageal stripe may also outline the recess and is formed when an air-filled esophagus and intervening pleura come in contact with the right lower lobe .
Superiorly, the recess is continuous with the subcarinal space and may demonstrate mild leftward convexity in that location .The middle third of the recess may be the most variable in appearance but typically is straight edged or shows mild leftward convexity. The lower third typically appears as a straight edge .Right superior convexity may be seen in children and younger adults but is abnormal in the elderly. Abnormal contour and convexity may be due to lymphadenopathy, hiatal hernias ,bronchopulmonary-foregut malformations, esophageal neoplasms, pleural abnormalities, and cardiomegaly with left atrial enlargement .
Although not considered a mediastinal line or stripe, the azygoesophageal recess تجويف remains an important mediastinal interface caused by differences in density between the mediastinum and the posteromedial portion of the right lower lobe. The azygoesophageal recess represents a space lying lateral or posterior to the esophagus and anterior to the spine, extending from the level of the anterior turn of the azygos vein to the level of the aortic hiatus inferiorly.The right infraazygos pleuroesophageal stripe may also outline the recess and is formed when an air-filled esophagus and intervening pleura come in contact with the right lower lobe .
Superiorly, the recess is continuous with the subcarinal space and may demonstrate mild leftward convexity in that location .The middle third of the recess may be the most variable in appearance but typically is straight edged or shows mild leftward convexity. The lower third typically appears as a straight edge .Right superior convexity may be seen in children and younger adults but is abnormal in the elderly. Abnormal contour and convexity may be due to lymphadenopathy, hiatal hernias ,bronchopulmonary-foregut malformations, esophageal neoplasms, pleural abnormalities, and cardiomegaly with left atrial enlargement .
Although not considered a mediastinal line or stripe, the azygoesophageal recess تجويف remains an important mediastinal interface caused by differences in density between the mediastinum and the posteromedial portion of the right lower lobe. The azygoesophageal recess represents a space lying lateral or posterior to the esophagus and anterior to the spine, extending from the level of the anterior turn of the azygos vein to the level of the aortic hiatus inferiorly.The right infraazygos pleuroesophageal stripe may also outline the recess and is formed when an air-filled esophagus and intervening pleura come in contact with the right lower lobe .
Superiorly, the recess is continuous with the subcarinal space and may demonstrate mild leftward convexity in that location .The middle third of the recess may be the most variable in appearance but typically is straight edged or shows mild leftward convexity. The lower third typically appears as a straight edge .Right superior convexity may be seen in children and younger adults but is abnormal in the elderly. Abnormal contour and convexity may be due to lymphadenopathy, hiatal hernias ,bronchopulmonary-foregut malformations, esophageal neoplasms, pleural abnormalities, and cardiomegaly with left atrial enlargement .
Although not considered a mediastinal line or stripe, the azygoesophageal recess تجويف remains an important mediastinal interface caused by differences in density between the mediastinum and the posteromedial portion of the right lower lobe. The azygoesophageal recess represents a space lying lateral or posterior to the esophagus and anterior to the spine, extending from the level of the anterior turn of the azygos vein to the level of the aortic hiatus inferiorly.The right infraazygos pleuroesophageal stripe may also outline the recess and is formed when an air-filled esophagus and intervening pleura come in contact with the right lower lobe .
Superiorly, the recess is continuous with the subcarinal space and may demonstrate mild leftward convexity in that location .The middle third of the recess may be the most variable in appearance but typically is straight edged or shows mild leftward convexity. The lower third typically appears as a straight edge .Right superior convexity may be seen in children and younger adults but is abnormal in the elderly. Abnormal contour and convexity may be due to lymphadenopathy, hiatal hernias ,bronchopulmonary-foregut malformations, esophageal neoplasms, pleural abnormalities, and cardiomegaly with left atrial enlargement .
Although not considered a mediastinal line or stripe, the azygoesophageal recess تجويف remains an important mediastinal interface caused by differences in density between the mediastinum and the posteromedial portion of the right lower lobe. The azygoesophageal recess represents a space lying lateral or posterior to the esophagus and anterior to the spine, extending from the level of the anterior turn of the azygos vein to the level of the aortic hiatus inferiorly.The right infraazygos pleuroesophageal stripe may also outline the recess and is formed when an air-filled esophagus and intervening pleura come in contact with the right lower lobe .
Superiorly, the recess is continuous with the subcarinal space and may demonstrate mild leftward convexity in that location .The middle third of the recess may be the most variable in appearance but typically is straight edged or shows mild leftward convexity. The lower third typically appears as a straight edge .Right superior convexity may be seen in children and younger adults but is abnormal in the elderly. Abnormal contour and convexity may be due to lymphadenopathy, hiatal hernias ,bronchopulmonary-foregut malformations, esophageal neoplasms, pleural abnormalities, and cardiomegaly with left atrial enlargement .
Abnormal contour and convexity may be due to lymphadenopathy, hiatal hernias فتق حجابيbronchopulmonary-foregut malformations, esophageal neoplasms, pleural abnormalities, and cardiomegaly with left atrial enlargement
CT scan shows a large hiatal hernia (arrow) that causes a rightward bulge of the distal azygoesophageal recess.
Chest radiograph with superimposed mediastinal stripes. Yellow: right paratracheal stripe. Light blue: right and left paraspinal stripes. Red: azygoesophageal stripe. Brown: pleuroesophageal stripe. Purple: anterior junction line complex. Pink: left subclavian artery border. Light green: posterior-superior junction line. Dark green: para-aortic line.
Chest radiograph with superimposed mediastinal stripes. Yellow: right paratracheal stripe. Light blue: right and left paraspinal stripes. Red: azygoesophageal stripe. Brown: pleuroesophageal stripe. Purple: anterior junction line complex. Pink: left subclavian artery border. Light green: posterior-superior junction line. Dark green: para-aortic line.