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Chest Wall and Diaphragm

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Pediatric Body MRI

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Abstract

The chest wall and diaphragm support the lungs and the physiologic motion of active breathing. The chest wall consists of the bones and cartilage of the thoracic cage, skin and subcutaneous tissue, muscles, nerves, and vessels. The diaphragm is a large dome-shaped skeletal muscle between the thoracic and abdominal compartments, which has numerous points of attachment to the body wall and skeleton.

There are several developmental variants of these structures that should not be mistaken for pathology on imaging, including different morphological forms of the ribs, sternum, and diaphragmatic contour. There is a wide spectrum of pathologies that can affect the chest wall and diaphragm, some of which are specific to the pediatric population. These include congenital and developmental anomalies (e.g., pectus deformities and diaphragmatic hernias), infectious disorders (cellulitis, abscess, and osteomyelitis), benign lesions (lipomatous tumors, fibrous tumors, osteochondromas, and numerous others), malignant tumors (sarcomas), and abnormalities of diaphragmatic motion (paralysis). Familiarity with the key clinical features and embryologic origins of these conditions is important for understanding their imaging appearance.

MR imaging is an excellent modality for evaluation of the chest wall and diaphragm, because of its high contrast resolution and multiplanar capability. This chapter reviews MR imaging of the pediatric chest wall and diaphragm, including technical factors of MR imaging, embryology, normal development and anatomy, and clinical and imaging features of various congenital and acquired disorders.

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Authors and Affiliations

  1. Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA

    Jessica Kurian

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  1. Jessica Kurian
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Editors and Affiliations

  1. Division of Thoracic Imaging, Department of Radiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

    Edward Y. Lee

  2. Division of Pediatric Radiology, Departments of Radiology and Pediatrics, The Children’s Hospital at Montefiore and Montefiore Medical Center Bronx, New York, NY, USA

    Mark C. Liszewski

  3. Division of Pediatric Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Michael S. Gee

  4. Alta Excelência Diagnóstica and Department of Radiology, Clínica Diagnóstico por Imagem (CDPI), Rio de Janeiro, Brazil

    Pedro Daltro

  5. Department of Interventional Radiology and Body Imaging, Nicklaus Children’s Hospital, Miami, FL, USA

    Ricardo Restrepo

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Kurian, J. (2020). Chest Wall and Diaphragm. In: Lee, E., Liszewski, M., Gee, M., Daltro, P., Restrepo, R. (eds) Pediatric Body MRI. Springer, Cham. https://doi.org/10.1007/978-3-030-31989-2_6

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