Frola C, Serrano J, Cantoni S, Casiglia M, Turtulici I, Loria F
IV Divisione di Radiologia, Ospedale S. Martino, Genova, Italy.
AJR Am J Roentgenol. 1995 Mar;164(3):599-601. doi: 10.2214/ajr.164.3.7863878.
Postthoracotomy atrophy of chest wall muscles results from nerve injury during surgery. After encountering patients with different patterns of chest wall muscular atrophy postthoracotomy, we performed this study to determine the relationship between type of thoracotomy and atrophic muscles as seen on CT scans.
CT scans of 58 patients who had previously undergone unilateral thoracotomy were reviewed. Forty patients had a posterolateral thoracotomy, and 18 had an anterolateral thoracotomy. In two cases, the incision extended posteriorly. Atrophy seen on CT scans was defined as a marked decrease in size or thickness of a muscle compared with the muscle on the other side.
Atrophy of the latissimus dorsi muscle and of the inferior portion of the serratus anterior muscle was detected on CT scans in 40 patients. No atrophy was found in 16 patients. The remaining two displayed atrophy only in the serratus anterior muscle. Atrophy of the latissimus dorsi muscle and of the inferior portion of the serratus anterior muscle developed in all patients who had a posterolateral thoracotomy. Atrophy developed in only two of the 18 patients who had an anterolateral thoracotomy, and in these two, the incision had been extended posteriorly.
A direct correlation was found between type of thoracotomy and site of atrophy of the chest wall muscles seen on CT scans. This finding may account for different CT appearances of the thoracic wall in patients who have had thoracic surgery.
开胸术后胸壁肌肉萎缩是手术过程中神经损伤所致。在遇到开胸术后胸壁肌肉萎缩模式不同的患者后，我们开展了本研究，以确定开胸类型与CT扫描所见萎缩肌肉之间的关系。
回顾了58例曾接受单侧开胸手术患者的CT扫描结果。40例患者接受后外侧开胸手术，18例接受前外侧开胸手术。2例患者的切口向后延伸。CT扫描所见萎缩定义为与对侧肌肉相比，某块肌肉的大小或厚度显著减小。
40例患者的CT扫描检测到背阔肌和前锯肌下部萎缩。16例患者未发现萎缩。其余2例仅在前锯肌出现萎缩。所有接受后外侧开胸手术的患者均出现背阔肌和前锯肌下部萎缩。18例接受前外侧开胸手术的患者中，仅2例出现萎缩，且这2例患者的切口向后延伸。
发现开胸类型与CT扫描所见胸壁肌肉萎缩部位之间存在直接关联。这一发现可能解释了接受胸外科手术患者胸壁的不同CT表现。
