Debnath Jyotindu, Sreedhar C M, Mukherjee Ruchira, Maurya V K, Patrikar Seema, Reddy Y R N
Professor, Department of Radiology, Armed Forces Medical College, Pune 411040, India.
Professor & HOD, Department of Radiology, Armed Forces Medical College, Pune 411040, India.
Med J Armed Forces India. 2018 Oct;74(4):337-345. doi: 10.1016/j.mjafi.2017.07.010. Epub 2017 Aug 30.
Knowledge of normal variation and measurements on a chest radiograph is essential to interpret any abnormality. There is paucity of information about normal measurement ranges and variations in young adolescents, particularly from Indian subcontinent. The aim of this study was to analyze certain normal variations on screening chest radiographs of healthy Indian adolescents and the objectives were to measure/assess (1) degree of inspiration, (2) cardiothoracic ratio (CTR), (3) presence of gastric fundic bubble, (4) fundocupolic distance, (5) presence of splenic flexure, (6) difference in height of diaphragmatic domes and (7) effect of inspiration on the CTR.
Digital chest radiographs obtained during routine medical examinations for all consecutive medical graduate aspirants in the year 2016 at a medical college, were analyzed for the above mentioned parameters using DICOM viewing software.
A total of 558 chest radiographs were analyzed. The mean age of the subjects was 18.50 (SD = 1.002) (range: 17-22 years). There were 497 (89.1%) male and 61 (10.9%) female. Degree of inspiration was at 5th, 6th, 7th and 8th ribs in 29 (5.1%), 259 (46.4%), 264 (47.3%) and 6 (1%) respectively. Mean maximum transverse cardiac diameter, internal thoracic diameter, CTR were 1153.22 ± 120.01, 2935.24 ± 224.86 and 0.39 ± 0.03 respectively. Females had slightly higher CTR (0.40 ± 0.035) as compared to the males (0.39 ± 0.032) ( = 0.009). Gastric fundic bubble was visualized in 91% subjects. Mean fundo-cupolic distance was 8.75 ± 8.00. Mean value for difference in the level of two domes of diaphragm was 15.28 ± 5.38.
The study highlights normal range of inspiration, CT ratio, fundocupolic distance and diaphragmatic dome level difference on screening chest radiographs in healthy Indian adolescents.
了解胸部X光片的正常变异和测量对于解读任何异常情况至关重要。关于青少年，尤其是来自印度次大陆的青少年的正常测量范围和变异的信息匮乏。本研究的目的是分析健康印度青少年筛查胸部X光片上的某些正常变异，目标是测量/评估（1）吸气程度，（2）心胸比率（CTR），（3）胃底气泡的存在，（4）胃杯距离，（5）脾曲的存在，（6）膈肌圆顶高度差异，以及（7）吸气对CTR的影响。
使用DICOM查看软件对2016年在一所医学院对所有连续医学毕业生申请者进行常规体检期间获得的数字胸部X光片进行上述参数分析。
共分析了558张胸部X光片。受试者的平均年龄为18.50（标准差 = 1.002）（范围：17 - 22岁）。男性有497人（89.1%），女性有61人（10.9%）。吸气程度分别在第5、6、7和8肋骨水平的有29人（5.1%）、259人（46.4%）、264人（47.3%）和6人（1%）。平均最大横向心脏直径、胸廓内径、CTR分别为1153.22 ± 120.01、2935.24 ± 224.86和0.39 ± 0.03。女性的CTR（0.40 ± 0.035）略高于男性（0.39 ± 0.032）（P = 0.009）。91%的受试者可见胃底气泡。平均胃杯距离为8.75 ± 8.00。双侧膈肌圆顶水平差异的平均值为15.28 ± 5.38。
该研究突出了健康印度青少年筛查胸部X光片上吸气、CT比率、胃杯距离和膈肌圆顶水平差异的正常范围。
