Miller F H, Fitzgerald S W, Donaldson J S
Department of Radiology, Northwestern Memorial Hospital, Chicago, IL 60611.
Radiographics. 1993 May;13(3):623-34. doi: 10.1148/radiographics.13.3.8316669.
The contour of the azygoesophageal recess (AER) as seen with computed tomography (CT) is an important indicator of mediastinal disorders. Radiologists must recognize, however, that the AER contour varies with patient age. The configuration of the AER is dextroconvex in children younger than 6 years, nonconcave (ie, equally divided between convex and straight) in children aged 6-12 years, and concave (or adult-like) in adolescents and young adults (aged 12-20 years). The cause of this variation is not certain; however, chest wall configuration does not seem to be an important factor. Although a convex AER is normal and common in pediatric patients, this normal appearance must be distinguished from that of mediastinal abnormalities (eg, foregut malformation cysts, vascular anomalies, lymphadenopathy), which can also produce obvious or subtle convexity of the AER. An appreciation for the age-related variation in AER configuration helps in the interpretation of CT scans. Criteria such as attenuation, morphologic characteristics, cephalocaudal extent, and multicompartmental involvement may be helpful in the differential diagnosis, but, generally, mediastinal abnormalities that alter the AER are nonspecific in appearance.
计算机断层扫描（CT）显示的奇静脉食管隐窝（AER）轮廓是纵隔疾病的重要指标。然而，放射科医生必须认识到，AER轮廓会随患者年龄而变化。6岁以下儿童的AER形态为右凸，6至12岁儿童为非凹形（即凸形和直线形平分），青少年和青年（12至20岁）为凹形（或类似成人）。这种变化的原因尚不确定；然而，胸壁形态似乎不是一个重要因素。虽然凸形AER在儿科患者中是正常且常见的，但这种正常表现必须与纵隔异常（如前肠畸形囊肿、血管异常、淋巴结病）相区分，这些异常也可导致AER明显或轻微凸出。了解AER形态随年龄的变化有助于解读CT扫描结果。诸如衰减、形态特征、头尾范围和多腔受累等标准可能有助于鉴别诊断，但一般来说，改变AER的纵隔异常在外观上是非特异性的。
