Literature DB >> 11354208

The mediastinum--is it wide?

C E Gleeson1, R L Spedding, L A Harding, M Caplan.   

Abstract

OBJECTIVE: To determine if the 8 cm upper limit for mediastinal width applies in the trauma setting of today. To define the upper limit of normal mediastinal width for supine chest films.
METHODS: A retrospective review of chest computed tomography scans was conducted to determine the width and position of the mediastinum within the supine chest. Radiographs were performed using a model that enabled the degree of mediastinal magnification to be ascertained in a variety of clinical settings.
RESULTS: The mean mediastinal width is 6.31 cm. With standard radiographical techniques this mediastinum is magnified to 8.93-10.07 cm. With minor adaptations in radiographical technique this can be reduced to 7.31-7.92 cm.
CONCLUSION: The 8 cm upper limit for normal mediastinal width, set in the 1970s does not apply in the modern trauma room. Changes in the position of the x ray cassette, and lengthening of the distance between the patient and the x ray source will significantly reduce magnification. A new range of upper limits is defined for the radiographical techniques possible in different trauma settings.

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Year:  2001        PMID: 11354208      PMCID: PMC1725572          DOI: 10.1136/emj.18.3.183

Source DB:  PubMed          Journal:  Emerg Med J        ISSN: 1472-0205            Impact factor:   2.740


  12 in total

1.  Roentgenologic diagnosis of traumatic rupture of the thoracic aorta.

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Journal:  AMA Arch Surg       Date:  1953-05

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Review 4.  The normal mediastinum in blunt traumatic rupture of the thoracic aorta and brachiocephalic arteries.

Authors:  J H Woodring
Journal:  J Emerg Med       Date:  1990 Jul-Aug       Impact factor: 1.484

5.  Incidence and significance of traumatic mediastinal haematoma.

Authors:  F Sandor
Journal:  Thorax       Date:  1967-01       Impact factor: 9.139

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Journal:  J Vasc Surg       Date:  1987-08       Impact factor: 4.268

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8.  Value of chest radiography in excluding traumatic aortic rupture.

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Journal:  Radiology       Date:  1987-05       Impact factor: 11.105

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Authors:  J T Sturm; D G Marsh; K C Bodily
Journal:  Surgery       Date:  1979-04       Impact factor: 3.982

10.  Blunt traumatic aortic rupture: detection with helical CT of the chest.

Authors:  M L Gavant; P G Menke; T Fabian; P A Flick; M J Graney; R E Gold
Journal:  Radiology       Date:  1995-10       Impact factor: 11.105

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  4 in total

Review 1.  Diagnosing traumatic rupture of the thoracic aorta in the emergency department.

Authors:  C E O'Conor
Journal:  Emerg Med J       Date:  2004-07       Impact factor: 2.740

2.  Diagnostic accuracy of mediastinal width measurement on posteroanterior and anteroposterior chest radiographs in the depiction of acute nontraumatic thoracic aortic dissection.

Authors:  Vincent Lai; Wai Kan Tsang; Wan Chi Chan; Tsz Wai Yeung
Journal:  Emerg Radiol       Date:  2012-03-14

3.  Mediastinal lipomatosis as a cause of low voltage complexes on electrocardiogram and widened mediastinum: A case report.

Authors:  Chethan Puttarajappa; Abhijeet Dhoble
Journal:  Cases J       Date:  2008-09-19

4.  Diagnostic value of chest radiography in the early management of severely injured patients with mediastinal vascular injury.

Authors:  Christopher Spering; Soehren Dirk Brauns; Rolf Lefering; Bertil Bouillon; Corinna Carla Dobroniak; László Füzesi; Mark-Tilmann Seitz; Katharina Jaeckle; Klaus Dresing; Wolfgang Lehmann; Stephan Frosch
Journal:  Eur J Trauma Emerg Surg       Date:  2022-04-07       Impact factor: 2.374

  4 in total

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