Anatomia Mediastino

Notas del editor

• #3 Las enfermedades mediastinales pueden ser difíciles de diagnosticar por Rx simple, debido a que la mayoría de estas patologias tienen densidad de tejido blando y están rodeadas por otras estructuras de tejido blando. Las lesiones mediastinales pueden causar crecimiento focal o difuso, desplazamiento, compresión o invadir estructuras adyascentes.
• #6 Ninguno es perfecto debido a que las estructuas y enfermedades generalmente cruzan las divisiones artificales. La causa mas frecuente de masa hiliar es la adenopatia o u Tu adyascente.
• #8 Medida del tamaño del timo: Los 2 lóbulos tímicos son medidos de manera separada. El ancho (W) corresponde al eje largo del lóbulo, como es visto en un corte axial de TC, y el grosor (T) corresponde al diámetro del eje corto. Cuando los 2 lóbulos son confluentes, el timo tiene una forma triangular o en cabeza de flecha. El timo es dividido en 2 mitades por una línea que pasa a través del ápex anterior de la glándula. El ancho y el grosor de cada lóbulo son medidos.
• #10 Anterior junction line. (a) Posteroanterior chest radiograph demonstrates the anterior junction line (arrow). (b) Computed tomographic (CT) scan shows the four layers of pleura that constitute the anterior junction line (arrow). The interface between aerated lung and pleura allows the line to be appreciated at conventional Radiography.
• #13 Varón de 83 años. La grasa puede ser vista lateral al arco Ao (AA) y a la arteria pulmonar principal (PA) y delimita la región de la ventana A-P. El ligamento del conducto arterioso (flecha) puede ser visto delineando el margen medial de la ventana A-P. Note además la vena braquiocefálica derecha, AD, VCS, ACI.
• #14 Right paratracheal stripe. (a) Posteroanterior chest radiograph shows the right paratracheal stripe (arrow). The azygos vein is seen at the inferior margin of the stripe at the tracheobronchial angle (arrowhead). (b) CT scan shows the right wall of the trachea with medial and lateral air–soft tissue interfaces caused by air within the tracheal lumen and right lung (arrow). These interfaces create the right paratracheal stripe. Note the position of the SVC (arrowhead), which explains why the paratracheal stripe is seen projecting through the SVC at radiography.
• #15 1. Right-sided aortic arch. (a) Posteroanterior chest radiograph demonstrates an abnormality in the right paratracheal region (arrow) with loss of the paratracheal stripe. Note, however, the absence of the aortic knuckle on the left. (b) CT scan shows a right-sided aortic arch (arrow), which explains the findings in a. 2. CT scans obtained at the levels of the aortic arch, show the left-sided SVC (arrow), which drains into the coronary sinus. 3.
• #18 a) Collimated posteroanterior chest radiograph shows the posterior junction line (arrow) projecting through the tracheal air column.
• #19 (a) On a collimated posteroanterior chest radiograph, the left paraspinal line (arrow) is seen separate and distinct from the vertebral body (black arrowhead) and the descending thoracic aorta (white arrowhead). (b) CT scan shows the left paraspinal line. The descending aorta holds the pleural reflection (arrow) away from the vertebral body, which allows the lung–soft tissue interface to be more tangential to the x-ray beam and therefore visualized as a line.
• #21 6 vasos
• #22 5 VASOS
• #30 GL precarinal en un Px con aneurisma de la Ao asc. El GL es ovoideo mas q redondo. Los estudios iniciales midieron el diámetro máximo del GL en el corte axial (LA). Debido a que existe menos variabilidad en el rango normal de los diámetros del eje corto, la mayoria de los autores recomiendan utilizar el diámetro del eje corto (SA). La medida LA fue de 15 mm, y la medida en el eje corto de 7 mm.
• #34 A. Enhanced CT scan at the level of the main pulmonary artery in a 55-year-old woman with left breast cancer demonstrating enlarged left internal mammary node (arrow). Note normal right internal mammary vessels (wavy arrow) and a portion of primary cancer in the left breast (asterisk). B. Non-enhanced CT scan in the same patient as in Figure 7 revealing enlarged, calcified para-aortic nodes (station 6; arrows), lying anterior and lateral to the aortic arch (A) below its superior margin. Also seen is right lower paratracheal lymphadenopathy (station 4R; open arrow). V = superior vena cava. C. Enhanced CT scan in a 73-year-old man with left lower lobe lung cancer (not shown) showing enlarged right lower paratracheal nodes (large arrow) lying medial to the azygos vein (V) and enlarged left lower paratracheal nodes (station 4L; open arrow) lying medial to ligamentum arteriosum (small arrows). Lower paratracheal nodes lie caudal to the top of the aortic arch.
• #35 A. Enhanced CT scan in a 58-year-old woman with carcinoid tumour showing enhancing subaortic lymphadenopathy (station 5; arrows) within the aortopulmonary window region. This group is located lateral to the ligamentum arteriosum (not seen). Note primary tumour in the left upper lobe (open arrow). B. Enhanced CT scan in a 65-year-old man with diffuse pulmonary lymphangitic carcinomatosis secondary to non-small cell lung cancer (not shown) demonstrating enlarged subcarinal (station 7; curved arrow), para-oesophageal (black arrow), right hilar (station 10R; large white arrows) and left hilar (station 10L; open arrow) nodes. Hilar nodes are outside the mediastinal pleura, below the top of the upper lobe bronchi. Note enlarged subaortic (arrowhead) and para-aortic (small white arrow) nodes. Oe = oesophagus C. Enhanced CT scan in a 65-year-old man with non-small cell lung cancer demonstrating metastasis to left pulmonary ligament node (station 9; curved arrow) from left lower lobe lung cancer (straight arrow). Oe = oesophagus, A = aorta.