新生儿和婴儿正中开胸术的放射学征象。

Radiographic signs of open median sternotomy in neonates and infants.

机构信息

Department of Radiology, Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA.

出版信息

Pediatr Radiol. 2012 Jun;42(6):674-8. doi: 10.1007/s00247-011-2313-y. Epub 2011 Dec 14.

DOI:10.1007/s00247-011-2313-y

PMID:22167052

Abstract

BACKGROUND

Leaving the median sternotomy wound open following cardiac surgery is employed to avoid cardiovascular compression. Horizontal struts can be used. Radiologists interpreting portable radiographs might be unaware of the open median sternotomy (OMS).

OBJECTIVE

To describe the frequency of radiographic signs of OMS and to increase awareness among radiologists to prevent misdiagnosis of pneumothorax and pneumomediastinum.

MATERIALS AND METHODS

Radiographs of 41 infants (17 girls/24 boys) with OMS were studied (age range 2 days to 8 months, mean 33 days). Central lucency and sternal edges were noted. Interclavicular distances before and after sternotomy were compared.

RESULTS

Central lucency was seen in 25/41 (61%) children. Sternal struts were apparent in 27 (66%). In 14 without struts, central lucency was present in 8 (57%). In 27 children with struts, central lucency was present in 17 (63%) and absent in 10 (37%). Split sternal centers were identified in 6/41 (15%). The mean interclavicular distance was 23.5 mm (SD = 4.39) before sternotomy and 38.2 mm (SD = 7.0 mm) after sternotomy (P < 0.001).

CONCLUSION

OMS has characteristic signs in the majority of cases. Recognition of these findings is useful and can prevent misinterpretation.

摘要

背景

心脏手术后，采用开放式正中胸骨切开术以避免心血管压迫，术中可使用水平支柱。解读便携式 X 光片的放射科医生可能不知道存在开放式正中胸骨切开术（OMS）。

目的

描述 OMS 的 X 光征象频率，提高放射科医生的认识，以防止气胸和纵隔气肿的误诊。

材料与方法

研究了 41 例 OMS 婴儿的 X 光片（17 名女孩/24 名男孩；年龄 2 天至 8 个月，平均 33 天）。记录中央透亮区和胸骨边缘。比较胸骨切开前后的胸锁关节距离。

结果

25/41（61%）例儿童可见中央透亮区。27 例（66%）可见胸骨支柱。在 14 例无支柱的儿童中，8 例（57%）存在中央透亮区。在 27 例有支柱的儿童中，17 例（63%）存在中央透亮区，10 例（37%）不存在。6/41（15%）例儿童可见胸骨中心分离。胸骨切开术前的平均胸锁关节距离为 23.5mm（SD=4.39），胸骨切开术后为 38.2mm（SD=7.0mm）（P<0.001）。