Pneumomediastinum CT: Difference between revisions

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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>:
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
*Naclerio V sign
**Seen in pneumomediastinum occurring often secondary to an oesophageal rupture but it is not entirely specific to that condition.
**Seen in pneumomediastinum occurring often secondary to an oesophageal rupture but it is not entirely specific to that condition.
*Gas anterior to [[pericardium]]
*[[Pneumopericardium]]
**[[Pneumopericardium]].
**Gas anterior to [[pericardium]]
*Gas around the [[pulmonary artery]] and main branches
*Ring around artery sign
**Ring around artery sign.
**Gas around [[Pulmonary artery|pulmonary artery and main branches]]
*Gas outlining major aortic branches
*Tubular artery sign
**Tubular artery sign.
**Gas outlining major [[Aorta|aortic branches]]
*Gas outlining bronchial wall
*Double bronchial wall sign
**Double bronchial wall sign.
**Gas outlining [[Bronchus|bronchial wall]]
*Continuous diaphragm sign
*Continuous [[Diaphragm (anatomy)|diaphragm]] sign
**Gas trapped posterior to the pericardium.
**Gas trapped posterior to [[pericardium]]
*Gas between [[pleura]] and [[diaphragm]]
*Extrapleural sign
**Extrapleural sign.
**Gas between [[parietal pleura]] and diaphragm
*Gas in [[pulmonary ligament]].
*Gas in [[pulmonary ligament]]
 
Pediatric pneumomediastinum has different appearances:
Pediatric pneumomediastinum has different appearances:
 
*Thymic wing sign
*Elevated [[thymus]]
**Elevated [[thymus]]
**Thymic wing sign.
*Haystack sign (the heart appears like a haystack in a Monet painting)
*Gas crossing the [[superior mediastinum]]
**Gas crossing the [[superior mediastinum]]
**Haystack sign (the heart appears like a haystack in a Monet painting).


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Revision as of 20:23, 17 December 2018

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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]:

Pediatric pneumomediastinum has different appearances:

  • Thymic wing sign
  • Haystack sign (the heart appears like a haystack in a Monet painting)

Images shown below are courtesy of RadsWiki.

References

  1. Taveras, J., & Ferrucci, J. (1986). Radiology. Diagnosis/imaging/intervention. 5 volumes. Annual revision service. R. Health Professions,Philadelphia, PA.
  2. 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.
  3. 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.
  4. Moseley, John E. (1960). "Loculated Pneumomediastinum in the Newborn". Radiology. 75 (5): 788–790. doi:10.1148/75.5.788. ISSN 0033-8419.
  5. Hammond DI (March 1984). "The "ring-around-the-artery" sign in pneumomediastinum". J Can Assoc Radiol. 35 (1): 88–9. PMID 6725378.
  6. Levin, Bertram (1973). "The continuous diaphragm sign". Clinical Radiology. 24 (3): 337–338. doi:10.1016/S0009-9260(73)80050-9. ISSN 0009-9260.
  7. 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.

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