Mediastinal interfaces on a chest radiograph result from contact between mediastinal structures and the adjacent lung, while mediastinal lines result from contact between the two lungs across the midline. A variation of mediastinal interface is mediastinal stripe, a narrow band produced by contact of both sides of a mediastinal structure with the lungs. Alterations in mediastinal interfaces and lines may be due to variations in normal anatomy, or may reflect the presence of abnormalities within the mediastinum. Familiarity with the various normal mediastinal interfaces and lines, and the changes that occur with disease is important for the interpretation of the chest radiograph and in the diagnosis of mediastinal abnormalities. The purpose of this pictorial essay is to illustrate the most important normal and abnormal interfaces and lines and also to correlate radiographic and CT findings.
Diagnosis ; Lung ; Mediastinum ; Radiography, Thoracic ; Recognition (Psychology)

The receiver operating characteristic (ROC) curve analysis was done to evaluate the effects of digital image processing techniques on the detectability of simulated pulmonary nodules and cysts in chest radiographs. Image processing techniques used were the contrast inversion, unsharp masking, and filtered equalization method. Simulated pulmonary nodules and cysts were generated by the computed program using Turbo-C language for personal computer. Each processed and unprocessed image sets of sixty images with pulmonary nodules and cysts and one hundred and twenty normal images were analyzed by three board-certified radiologists and four senior residents training in diagnostic radiology by five rating category. Area under the ROC curve was calculated using the trapezoidal rule. Mean area under the ROC curve of seven radiologists of the unprocessed image was 0.6360±0.0583, contrast inversion was 0.5660±0.0478, unsharp masking was 0.7534±0.0355 and filtered equalization was 0.6915±0.0472. Unsharp masking(p<0.01) and filtered equalization image(p<0.05) was statistically significant than unprocessed image. Digital chest radiographs processed by the unsharp masking method significantly increased the detectability of simulated pulmonary nodules and cysts overlapped with mediastinum and pulmonary cysts in free lung fields.
Lung ; Masks ; Mediastinum ; Methods ; Microcomputers ; Radiography, Thoracic* ; ROC Curve ; Thorax*

Intrathoracic ectopia denotes either a partial or a complete protrusion of the kidney above the diaphragm into the postecioc mediastinum and is a very rare developmental anomaly. The vast majority of patient with this anomaly has remained asymptomatic but discovered on routine chest radiographs. The diagnosis is made following a routine chest X-ray, lateral chest film and excretory urography. Herein we report a case of intrathoracic kidney which was found incidentally during the routine check-up and normal function of kidney.
Diagnosis ; Diaphragm ; Humans ; Kidney* ; Mediastinum ; Radiography, Thoracic ; Thorax ; Urography

Malignant transformation of teratoma in the anterior mediastinum is rare; the mass usually has a long history and is seen in older patients. We report a case of teratoma with malignant transformation in the anterior mediastinum, complicated by rupture. CT revealed a lobulated, inhomogeneous cystic mass with a fat com-ponent and wall calcifications. The lateral wall was disrupted and consolidation in the adjacent left upper lobe was noted, suggesting rupture. A heterogeneously enhanced solid portion, obliterating the fat plane between the mass and the great vessels was present in the medial aspect of the mass, and pathologic examina-tion demonstrated the presence of adenocarcinoma.
Adenocarcinoma/pathology ; Human ; Male ; Mediastinal Neoplasms/pathology/*radiography ; Mediastinum/pathology ; Middle Age ; Rupture, Spontaneous ; Teratoma/pathology/*radiography

The fibromatosis is a rare timorous with local invasion, but is not metastasized distantly. This term should not be applied to nonspecific reactive fibrous proliferations that are part of an inflammatory process of are secondary to injury of hemorrhage and have no tendency toward growth or recurrence. It arises principally from the connective tissue of muscle and overlying fascia or aponeurosis (musculoaponeurotic fibromatosis), and chiefly affects the muscle of shoulder, pelvic girdle, and extremity. The term 'aggressive fibromatosis' is also employed to describe this disease, but it is impossible to predict the clinical course in the individual case. The fibromatosis arising in the mediastinum is very rare, and the report about it is nearly absent. The plain radiography shows merely mass with soft tissue density. The CT demonstrates a poorly defined homogenous or heterogeneous mass, isodense with skeletal muscle on precontrast-images, and slightly hyperdense to muscle on postcontrast-scan. Accurate delineation between the tumor & surrounding tissue is vague or frequently impossible. The authors experienced one case of the mediastinal fibromatosis recently and report the case with review of concerned literature.
Connective Tissue ; Extremities ; Fascia ; Fibroma* ; Hemorrhage ; Indonesia ; Mediastinum ; Muscle, Skeletal ; Radiography ; Recurrence ; Shoulder

We report a patient who developed a hydromediastinum associated with the insertion of a central venous catheter. A 32-year-old male, who presented for left nephroureterectomy, had a central venous catheter inserted after general anesthesia. The patient subsequently showed acute respiratory distress after extubation. His right neck was severely edematous and the chest radiograph revealed a widened mediastinal shadow. The exploratory neck incision showed fluid collection at the neck and mediastinum.
Adult ; Anesthesia, General ; Catheterization* ; Catheters* ; Central Venous Catheters ; Humans ; Jugular Veins* ; Male ; Mediastinum ; Neck ; Radiography, Thoracic

A 44-year-old man was transferred to our department for mediastinal mass. He had suffered from only an easily fatiguable condition for 1 month. A physical examination and laboratory finding of the patient disclosed no abnormality. A chest radiograph showed a soft tissue tumor in the posterior mediastinum. It was well circumscribed and ovoid. Invasions to adjacent organs were not seen. Therefore it was though the 5th intercostal space. The tumor mass was attached to the visceral pleura of the right upper lobe by a pedicle and this pedunculated tumor laid entirely within the pleural cavity. Excision of the tumor which measured 7x7x3cm was done easily. Pathologic studies confirmed the diagnosis of localized fibrous tumor of the pleura. Localized fibrous tumor of the pleura is rare, This tumor along ith the evidence from ultrastructural and immunohistochemical studies has led most researchers to conclude that localized fibrous tumor is not of the mesothelial origin but arises in the submesothelial connective tissue.
Adult ; Connective Tissue ; Diagnosis ; Humans ; Mediastinum ; Mesothelioma ; Physical Examination ; Pleura* ; Pleural Cavity ; Pleural Neoplasms ; Radiography, Thoracic

A thymic cyst in the middle mediastinum adjacent to the right pericardium is extremely rare. We report a case of a large thymic cyst in the right cardiophrenic angle, compressing the right atrium, which was presented as a cardiomegaly on the chest radiograph and a pericardial cyst on the echocardiography. The definitive diagnosis was confirmed using surgical resection and biopsy.
Biopsy ; Cardiomegaly ; Diagnosis ; Echocardiography ; Heart Atria ; Magnetic Resonance Imaging ; Mediastinal Cyst* ; Mediastinum* ; Pericardium ; Radiography, Thoracic

PURPOSE: To compare image quality of storage phosphor digital radiography(DR) with film-screen radiography in portable chest imaging, and to assess the minimum X-ray dose that can be applied to DR in adults without image degradation, and also to compare image qualities of low dose and standard dose DR. Materials and Methalos: A geometrical phantom similar to the human thorax was imaged by a portable radiographic unit with fixed kVp and variable m^s in both film-screen and DR systems. Three radiologists scored the images by four grades in four categories of 1) contrast between mediastinum and lung, 2) definition of the nodule in the lung, 3) definition of another nodule through the mediastinal shadow, and 4) grainess(noise : assessed only in DR). Additionally, portable chest images were obtained in 10 patients in a intensive care unit by film-screen, standard dose and half dose DR in consecutive days. The same readers scored the images by four grades in six categories of 1) the lungs and hila, 2) the mediastinum, 3) subphrenic area. 4) musculoskeletal shadow, 5) tubes and lines, and 6) grainess (only in DR). The images with superior quality were assessed by paired t-test. RESULTS: In phantom study, the minimum dose of digital images scored 3 or more by all readers was 39% of the standard dose. In patient study, DR was superior to film-screen radiography in all categories except tube and line. Low dose DR was not inferior to standard dose DR in five categories other than grainess to two readers or more. CONCLUSION: In portable chest imaging, storage phosphor DR image was superior to conventional film-screen radiography and half dose DR was comparable to standard dose DR despite of more noise.
Adult ; Humans ; Intensive Care Units ; Lung ; Mediastinum ; Noise ; Radiographic Image Enhancement* ; Radiography ; Thorax*

PURPOSE: To compare image quality of storage phosphor digital radiography(DR) with film-screen radiography in portable chest imaging, and to assess the minimum X-ray dose that can be applied to DR in adults without image degradation, and also to compare image qualities of low dose and standard dose DR. Materials and Methalos: A geometrical phantom similar to the human thorax was imaged by a portable radiographic unit with fixed kVp and variable m^s in both film-screen and DR systems. Three radiologists scored the images by four grades in four categories of 1) contrast between mediastinum and lung, 2) definition of the nodule in the lung, 3) definition of another nodule through the mediastinal shadow, and 4) grainess(noise : assessed only in DR). Additionally, portable chest images were obtained in 10 patients in a intensive care unit by film-screen, standard dose and half dose DR in consecutive days. The same readers scored the images by four grades in six categories of 1) the lungs and hila, 2) the mediastinum, 3) subphrenic area. 4) musculoskeletal shadow, 5) tubes and lines, and 6) grainess (only in DR). The images with superior quality were assessed by paired t-test. RESULTS: In phantom study, the minimum dose of digital images scored 3 or more by all readers was 39% of the standard dose. In patient study, DR was superior to film-screen radiography in all categories except tube and line. Low dose DR was not inferior to standard dose DR in five categories other than grainess to two readers or more. CONCLUSION: In portable chest imaging, storage phosphor DR image was superior to conventional film-screen radiography and half dose DR was comparable to standard dose DR despite of more noise.
Adult ; Humans ; Intensive Care Units ; Lung ; Mediastinum ; Noise ; Radiographic Image Enhancement* ; Radiography ; Thorax*