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Fissures, Lines, and Stripes

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Abstract

Knowledge of the normal and abnormal appearance of fissures, lines, and stripes is essential to interpreting chest images. This chapter describes various fissures, the anterior and posterior junction lines, right paratracheal stripe, posterior tracheal stripe, paravertebral stripes, azygoesophageal line and recess, and the hilum overlay sign.

Keywords

  • Minor fissure
  • Major fissure
  • Azygos fissure
  • Anterior junction line
  • Posterior junction line
  • Right paratracheal stripe
  • Posterior tracheal stripe
  • Paravertebral stripe
  • Azygoesophageal recess
  • Hilum overlay sign

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References

  1. Gibbs JM, Chandrasekhar CA, Ferguson EC, Oldham SAA. Lines and stripes: where did they go? —from conventional radiography to CT. Radiographics. 2007;27:33–48.

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  2. Whitten CR, Khan S, Munneke GJ, Grubnic S. A diagnostic approach to mediastinal abnormalities. Radiographics. 2007;27:657–71.

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Fig. e2.1

(a) Normal anterior junction line (arrows) [1] (TIF 943 kb)

Fig. e2.1

(b) Normal anterior junction line (arrows) [1] (TIF 679 kb)

Fig. e2.2

Abnormal anterior junction line. (a) Following right middle lobectomy, the anterior junction line (arrows) is displaced to the right. Note also the volume loss in the right lung as demonstrated by elevation of the right hemidiaphragm [1] (TIF 1011 kb)

Fig. e2.2

Abnormal anterior junction line. (b) Following right middle lobectomy, the anterior junction line (arrows) is displaced to the right. Note also the volume loss in the right lung as demonstrated by elevation of the right hemidiaphragm [1] (TIF 565 kb)

Fig. e2.3

(a) Normal posterior junction line (arrow) [2] (TIF 765 kb)

Fig. e2.3

(b) Normal posterior junction line (arrow) [2] (TIF 505 kb)

Fig. e2.4

Abnormal posterior junction line (bronchogenic cyst). (a) The mass (arrow) extends above the level of the clavicle (indicating a posterior lesion) and has a well-demarcated outline due to the interface with adjacent lung (arrowhead) [2] (TIF 682 kb)

Fig. e2.4

Abnormal posterior junction line (bronchogenic cyst). (b) The mass (arrow) extends above the level of the clavicle (indicating a posterior lesion) and has a well-demarcated outline due to the interface with adjacent lung (arrowhead) [2] (TIF 733 kb)

Fig. e2.5

Hilum overlay sign. (a) Left hilar mass overlaps the left main pulmonary artery (arrow). Compare this with the normal appearance of the right main pulmonary artery (TIF 682 kb)

Fig. e2.5

Hilum overlay sign. (b) Lateral view shows an anterior mediastinal mass (arrows) (TIF 954 kb)

Fig. e2.6

Hilum overlay sign (lymphoma). (a) Clear depiction of the right hilum (white arrow) indicates that the mass is either anterior or posterior to it. Moreover, the descending aorta is clearly seen (black arrow), indicating that the mass is not within the posterior mediastinum (TIF 800 kb)

Fig. e2.6

Hilum overlay sign (lymphoma). (b) CT image confirms the large anterior mediastinal mass. The anterior junction line is obliterated, whereas the interfaces of the lung with the hilar vessels (arrow) and aorta (arrowhead) are preserved [2] (TIF 627 kb)

Fig. e2.7

Abnormal right paratracheal stripe (ectopic parathyroid adenoma). (a) The large mass widening of the right paratracheal stripe (arrow) is associated with diffuse osteopenia (arrowheads) due to primary hyperparathyroidism [2] (TIF 687 kb)

Fig. e2.7

Abnormal right paratracheal stripe (ectopic parathyroid adenoma). (b) The large mass widening of the right paratracheal stripe (arrow) is associated with diffuse osteopenia (arrowheads) due to primary hyperparathyroidism [2] (TIF 204 kb)

Fig. e2.8

Abnormal AP window. (a) The abnormal convex border of the AP window is caused by lymphadenopathy (arrow) [2] (TIF 729 kb)

Fig. e2.8

Abnormal AP window. (b) The abnormal convex border of the AP window is caused by lymphadenopathy (arrow) [2] (TIF 920 kb)

Fig. e2.9

Abnormal left paraspinal line. (a) The focal lateral bulge (arrow) is due to extensive esophageal varices in this patient with cirrhosis [1] (TIF 797 kb)

Fig. e2.9

Abnormal left paraspinal line. (b) The focal lateral bulge (arrow) is due to extensive esophageal varices in this patient with cirrhosis [1] (TIF 934 kb)

Fig. e2.10

Normal retrosternal stripe (arrow) (TIF 930 kb)

Fig. e2.11

Abnormal retrosternal stripe. (a) Irregular widening of the retrosternal stripe represents hemorrhage following reconstructive sternal surgery (TIF 719 kb)

Fig. e2.11

Abnormal retrosternal stripe. (b) Previous normal image in the same patient (TIF 807 kb)

Fig. e2.12

Abnormal posterior tracheal stripe (achalasia). (a) Widening of the posterior tracheal stripe (arrows) (TIF 1034 kb)

Fig. e2.12

Abnormal posterior tracheal stripe (achalasia). (b) CT image demonstrates a dilated esophagus (arrow) filled with food and contrast material [1] (TIF 1031 kb)

Fig. e2.13

Normal azygoesophageal recess. (a) The azygoesophageal recess (arrows) has a mild leftward convexity superiorly and a straight edge inferiorly (TIF 994 kb)

Fig. e2.13

Normal azygoesophageal recess. (b) CT image shows that the azygoesophageal recess (arrow) is an interface formed by the right lower lobe outlining the mediastinum adjacent to the esophagus and azygos vein [1] (TIF 849 kb)

Fig. e2.14

Abnormal azygoesophageal recess (bronchogenic cyst). (a) Subcarinal mass with increased opacity (∗), splaying of the carina, and abnormal convexity of the upper and middle thirds of the azygoesophageal line (arrowheads) (TIF 748 kb)

Fig. e2.14

Abnormal azygoesophageal recess (bronchogenic cyst). (b) CT image confirms the presence of a subcarinal mass (arrow) [2] (TIF 947 kb)

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Eisenberg, R.L. (2020). Fissures, Lines, and Stripes. In: What Radiology Residents Need to Know: Chest Radiology . Springer, Cham. https://doi.org/10.1007/978-3-030-16826-1_2

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  • DOI: https://doi.org/10.1007/978-3-030-16826-1_2

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-16825-4

  • Online ISBN: 978-3-030-16826-1

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