Pneumomediastinum CT: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Pneumomediastinum}} | {{Pneumomediastinum}} | ||
{{CMG}} | {{CMG}} {{AE}} {{Trusha}} | ||
==Overview== | ==Overview== | ||
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==CT== | ==CT== | ||
The following finding(s) on performing CT-scan of the chest is confirmatory for pneumomediastinum: | The following finding(s) on performing CT-scan of the chest is confirmatory for pneumomediastinum<ref>{{cite book |title=Taveras, J., & Ferrucci, J. (1986). Radiology. Diagnosis/imaging/intervention. 5 volumes. Annual revision service. R. Health Professions,Philadelphia, PA}}</ref><ref name="SandlerLlbshltz1975">{{cite journal|last1=Sandler|first1=Carl M.|last2=Llbshltz|first2=Herman I.|last3=Marks|first3=Gerald|last4=Libshitz|first4=Herman I.|title=Pneumoperitoneum, Pneumomediastinum and Pneumopericardium Following Dental Extraction|journal=Radiology|volume=115|issue=3|year=1975|pages=539–540|issn=0033-8419|doi=10.1148/15.3.539}}</ref><ref name="KimYoo2016">{{cite journal|last1=Kim|first1=Hye Rin|last2=Yoo|first2=Seung Min|last3=Lee|first3=Hwa Yeon|last4=Han|first4=Jin Hee|last5=Frazier|first5=Aletta A|last6=White|first6=Charles S|title=Presence of subpleural pulmonary interstitial emphysema as an indication of single or multiple alveolar ruptures on CT in patients with spontaneous pneumomediastinum|journal=Acta Radiologica|volume=57|issue=12|year=2016|pages=1483–1489|issn=0284-1851|doi=10.1177/0284185116629830}}</ref><ref name="Moseley1960">{{cite journal|last1=Moseley|first1=John E.|title=Loculated Pneumomediastinum in the Newborn|journal=Radiology|volume=75|issue=5|year=1960|pages=788–790|issn=0033-8419|doi=10.1148/75.5.788}}</ref><ref name="pmid6725378">{{cite journal |vauthors=Hammond DI |title=The "ring-around-the-artery" sign in pneumomediastinum |journal=J Can Assoc Radiol |volume=35 |issue=1 |pages=88–9 |date=March 1984 |pmid=6725378 |doi= |url=}}</ref><ref name="Levin1973">{{cite journal|last1=Levin|first1=Bertram|title=The continuous diaphragm sign|journal=Clinical Radiology|volume=24|issue=3|year=1973|pages=337–338|issn=00099260|doi=10.1016/S0009-9260(73)80050-9}}</ref><ref name="LillardAllen1965">{{cite journal|last1=Lillard|first1=Richard L.|last2=Allen|first2=Parker|title=The Extrapleural Air Sign in Pneumomediastinum|journal=Radiology|volume=85|issue=6|year=1965|pages=1093–1098|issn=0033-8419|doi=10.1148/85.6.1093}}</ref>: | ||
*Subcutaneous emphysema. | *[[Subcutaneous emphysema]]. | ||
*Naclerio V sign: Seen in pneumomediastinum occurring often secondary to an oesophageal rupture but it is not entirely specific to that condition. | *Naclerio V sign: Seen in pneumomediastinum occurring often secondary to an oesophageal rupture but it is not entirely specific to that condition. | ||
*Gas anterior to pericardium: | *Gas anterior to [[pericardium]]: [[Pneumopericardium]]. | ||
*Gas around the pulmonary artery and main branches: | *Gas around the [[pulmonary artery]] and main branches: Ring around artery sign. | ||
*Gas outlining major aortic branches: | *Gas outlining major aortic branches: Tubular artery sign. | ||
*Gas outlining bronchial wall: | *Gas outlining bronchial wall: Double bronchial wall sign. | ||
*Continuous diaphragm sign: | *Continuous diaphragm sign: Gas trapped posterior to the pericardium. | ||
*Gas between | *Gas between [[pleura]] and [[diaphragm]]: extrapleural sign. | ||
*Gas in pulmonary ligament. | *Gas in [[pulmonary ligament]]. | ||
Pediatric pneumomediastinum has different appearances: | Pediatric pneumomediastinum has different appearances: | ||
*Elevated thymus: thymic wing sign. | *Elevated [[thymus]]: thymic wing sign. | ||
*Gas crossing the superior mediastinum: haystack sign (the heart appears like a haystack in a Monet painting). | *Gas crossing the [[superior mediastinum]]: haystack sign (the heart appears like a haystack in a Monet painting). | ||
<gallery> | <gallery> | ||
Revision as of 18:38, 14 December 2018
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Pneumomediastinum Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Pneumomediastinum CT On the Web |
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American Roentgen Ray Society Images of Pneumomediastinum CT |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Trusha Tank, M.D.[2]
Overview
The diagnosis can be confirmed via chest X-ray showing a radiolucent outline around the heart and mediastinum or via CT scanning of the thorax.
CT
The following finding(s) on performing CT-scan of the chest is confirmatory for pneumomediastinum[1][2][3][4][5][6][7]:
- Subcutaneous emphysema.
- Naclerio V sign: Seen in pneumomediastinum occurring often secondary to an oesophageal rupture but it is not entirely specific to that condition.
- Gas anterior to pericardium: Pneumopericardium.
- Gas around the pulmonary artery and main branches: Ring around artery sign.
- Gas outlining major aortic branches: Tubular artery sign.
- Gas outlining bronchial wall: Double bronchial wall sign.
- Continuous diaphragm sign: Gas trapped posterior to the pericardium.
- Gas between pleura and diaphragm: extrapleural sign.
- Gas in pulmonary ligament.
Pediatric pneumomediastinum has different appearances:
- Elevated thymus: thymic wing sign.
- Gas crossing the superior mediastinum: haystack sign (the heart appears like a haystack in a Monet painting).
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A CT scan showing air in the mediastinum
Images shown below are courtesy of RadsWiki.
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Pneumomediastinum -
Pneumomediastinum
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Pneumomediastinum and pneumothorax -
Pneumomediastinum and pneumothorax
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Pneumomediastinum and pneumothorax and subcutaneous emphysema
References
- ↑ Taveras, J., & Ferrucci, J. (1986). Radiology. Diagnosis/imaging/intervention. 5 volumes. Annual revision service. R. Health Professions,Philadelphia, PA.
- ↑ Sandler, Carl M.; Llbshltz, Herman I.; Marks, Gerald; Libshitz, Herman I. (1975). "Pneumoperitoneum, Pneumomediastinum and Pneumopericardium Following Dental Extraction". Radiology. 115 (3): 539–540. doi:10.1148/15.3.539. ISSN 0033-8419.
- ↑ Kim, Hye Rin; Yoo, Seung Min; Lee, Hwa Yeon; Han, Jin Hee; Frazier, Aletta A; White, Charles S (2016). "Presence of subpleural pulmonary interstitial emphysema as an indication of single or multiple alveolar ruptures on CT in patients with spontaneous pneumomediastinum". Acta Radiologica. 57 (12): 1483–1489. doi:10.1177/0284185116629830. ISSN 0284-1851.
- ↑ Moseley, John E. (1960). "Loculated Pneumomediastinum in the Newborn". Radiology. 75 (5): 788–790. doi:10.1148/75.5.788. ISSN 0033-8419.
- ↑ Hammond DI (March 1984). "The "ring-around-the-artery" sign in pneumomediastinum". J Can Assoc Radiol. 35 (1): 88–9. PMID 6725378.
- ↑ Levin, Bertram (1973). "The continuous diaphragm sign". Clinical Radiology. 24 (3): 337–338. doi:10.1016/S0009-9260(73)80050-9. ISSN 0009-9260.
- ↑ Lillard, Richard L.; Allen, Parker (1965). "The Extrapleural Air Sign in Pneumomediastinum". Radiology. 85 (6): 1093–1098. doi:10.1148/85.6.1093. ISSN 0033-8419.