Donnelly L F, Taylor C N, Emery K H, Brody A S
Department of Radiology, Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA.
Radiology. 1997 Mar;202(3):829-31. doi: 10.1148/radiology.202.3.9051041.
To review results from cross-sectional imaging studies performed to evaluate asymptomatic anterior chest wall lesions in children.
All magnetic resonance (MR) images or computed tomographic (CT) scans of the chest obtained from 1989 to 1996 for evaluation of asymptomatic, palpable, focal, anterior chest wall lesions in otherwise healthy children were reviewed. Fifty-one children were considered for the study. Findings from 27 examinations in 27 children (13 underwent MR imaging, and 14 underwent CT) were included in the study. All children had normal radiographs of the region. Twenty-four patients did not meet the inclusion criteria and were excluded.
The cause of the lesion palpated at physical examination was identified in 26 of 27 patients: prominent anterior convex ribs in 10 patients; "tilted" sternum in six; prominent asymmetric costal cartilage in four; bifid rib in one; and well-defined, small (< 1-cm) subcutaneous nodule adjacent to costal cartilage in five. One examination demonstrated no abnormality. Of the 27 patients, none required treatment.
All palpable, asymptomatic, anterior chest wall lesions were benign and usually related to normal variations in the bone or cartilage of the chest wall. The low yield of cross-sectional imaging performed for evaluation of these asymptomatic "bumps" should be considered when decisions are made with regard to imaging.
回顾对儿童无症状性前胸壁病变进行横断面成像研究的结果。
回顾了1989年至1996年期间获取的所有胸部磁共振（MR）图像或计算机断层扫描（CT），这些检查是为评估其他方面健康的儿童无症状、可触及的局灶性前胸壁病变。51名儿童被纳入研究考虑范围。本研究纳入了27名儿童27次检查的结果（13名接受了MR成像，14名接受了CT）。所有儿童该区域的X线片均正常。24名患者不符合纳入标准而被排除。
27例患者中有26例在体格检查时触诊到的病变原因得以明确：10例为前胸壁肋骨明显前凸；6例为“倾斜”胸骨；4例为肋软骨明显不对称；1例为分叉肋骨；5例为肋软骨旁边界清晰的小（<1cm）皮下结节。1次检查未显示异常。27例患者中无人需要治疗。
所有可触及的无症状前胸壁病变均为良性，通常与胸壁骨骼或软骨的正常变异有关。在决定是否进行成像检查时，应考虑对这些无症状“肿块”进行横断面成像检查的低阳性率。
