Kurihara Y
Department of Radiology, St. Marianna University School of Medicine.
Nihon Igaku Hoshasen Gakkai Zasshi. 1990 Nov 25;50(11):1387-95.
To our knowledge, there have been few reports on radiological analysis of the mediastinum after lobectomy. The author reviewed 36 cases with pre and postoperative plain films and CT to evaluate anatomical changes of the mediastinum and causes of obliteration of mediastinal lines. The mediastinum was always shifted to the surgical side (2.7 cm) with rotation (10 degrees). The anterior junction line was thickened uniformly by proliferation of adipose tissue. On plain films, mediastinal lines were obliterated on the side of surgery. Contralateral side could be affected only in left lobectomy. The anatomical changes of mediastinum after lobectomy may be composed of following three factors; rotational shift, proliferation of adipose tissue, and secondary changes due to former two factors. The rotational shift and proliferation of adipose tissue have significant effects on anteriorly located mediastinal lines such as paratracheal line and the margin of the superior vena cava (SVC). The lines of the other side to the resected lobe could also be obliterated by these two factors.
据我们所知，关于肺叶切除术后纵隔的放射学分析报道较少。作者回顾了36例患者术前和术后的平片及CT，以评估纵隔的解剖学变化及纵隔线消失的原因。纵隔总是向手术侧移位（2.7厘米）并伴有旋转（10度）。前交界线因脂肪组织增生而均匀增厚。在平片上，手术侧的纵隔线消失。对侧仅在左肺叶切除时可能受影响。肺叶切除术后纵隔的解剖学变化可能由以下三个因素构成：旋转移位、脂肪组织增生以及前两个因素引起的继发性改变。旋转移位和脂肪组织增生对位于前方的纵隔线，如气管旁线和上腔静脉（SVC）边缘有显著影响。切除肺叶对侧的纵隔线也可能因这两个因素而消失。
